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Individual

DR. RAJAGOPAL K REDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D. FA.C.C.

Contact information

Practice address
1431 N WESTERN AVE, SUITE 503, CHICAGO, IL 60622-1797
(773) 489-7979
(773) 489-7908
Mailing address
1431 N WESTERN AVE, SUITE 503, CHICAGO, IL 60622-1797
(773) 489-7979
(773) 489-7908

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-055690
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036055690
IL
01
31600496
BCBS
IL
01
36-3593720
FEIN
Enumeration date
01/26/2007
Last updated
03/07/2023
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