Individual
PRATHIMA KAPADI BASAVA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
836 W WELLINGTON AVE, ADVOCATE ILLINOIS MASONIC MEDICAL CENTER, CHICAGO, IL 60657-5147
(501) 352-9983
Mailing address
856 W NELSON ST, APT. 701, CHICAGO, IL 60657-5152
(501) 352-9983
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E-7615
AR
207R00000X
Internal Medicine Physician
MD60610289
WA
208M00000X
Hospitalist Physician
Primary
E-7615
AR
390200000X
Student in an Organized Health Care Education/Training Program
125056499
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-7615
ARKANSAS STATE MEDICAL BOARD LICENSE
AR
Enumeration date
07/31/2009
Last updated
04/14/2023
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