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Individual

DR. V ARAVIND REDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
625 S 5TH ST STE B, WATSEKA, IL 60970-1863
(815) 432-2225
(815) 432-3623
Mailing address
625 S 5TH ST STE B, WATSEKA, IL 60970-1863
(815) 432-2225
(815) 432-3623

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036075574
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0003800069
BLUE CROSS BLUE SHIELD
IL
05
036075574
IL
01
060063395
RAILROAD MEDICARE
01
14D0981553
CLIA
05
200098830A
IN
01
775860
MEDICARE PROVIDER
IL
Enumeration date
08/29/2007
Last updated
02/01/2008
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