Individual
MANASA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
1308 NW 158TH ST, EDMOND, OK 73013-1378
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036148876
IL
Other
Enumeration date
05/08/2016
Last updated
07/09/2019
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