Individual
KRISHNA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2911 SYCAMORE RD, DEKALB, IL 60115-9205
(815) 756-1521
Mailing address
PO BOX 2184, INDIANAPOLIS, IN 46206-2184
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036047067
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009847
HEALTH ALLIANCE
—
05
—
036047067
—
IL
01
—
1922250
BCBS IL
IL
01
—
220010789
RAILROAD MEDICARE
—
01
—
32913278
CHAMPUS
—
01
—
394593
HEALTHLINK
IL
Enumeration date
09/15/2006
Last updated
07/27/2010
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