Individual
DR. PRAVEEN NALLAPAREDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4320 FIR ST UNIT 210, EAST CHICAGO, IN 46312-8410
(219) 836-6002
Mailing address
701 SUPERIOR AVE, STE G, MUNSTER, IN 46321-4037
(219) 922-3040
(219) 922-3048
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01072083A
IN
207RG0100X
Gastroenterology Physician
036.118276
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118276
—
IL
05
—
100202290
—
IN
01
—
105715
ANTHEM
IN
01
—
221956
IL MEDICAID PTAN
IL
01
—
628340
MEDICARE PTAN
IN
Enumeration date
07/08/2008
Last updated
12/05/2019
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