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DHEERAJ BODDI REDDY MD
NPI 1336933530
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since April 04, 2025
530 NE GLEN OAK AVE, PEORIA, IL 61637(855) 673-4325 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dheeraj Boddi Reddy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DHEERAJ BODDI REDDY MD (NPI 1336933530) is an individual student in an organized health care education/training program in Peoria, Illinois, licensed in (90200000X) and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1336933530
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDHEERAJ BODDI REDDYCredential: MD
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address6631 N Greenwich PlPeoria, IL 61615-6616 · (312) 608-9890 · Fax (312) 608-9890
Phone(855) 673-4325
Sole ProprietorYes
Enumeration DateApril 4, 2025
NPPES CertifiedApril 4, 2025
✔ NPI 1336933530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed · 90200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
530 NE GLEN OAK AVE, Peoria, IL 61637
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPAK S NAIR M.D.
Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ERIC TYLER AMPARAN MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2274
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dheeraj Boddi Reddy's NPI number?

The NPI number for Dheeraj Boddi Reddy is 1336933530. It was assigned to this individual provider in the NPPES registry on April 4, 2025.

Where is Dheeraj Boddi Reddy located?

Dheeraj Boddi Reddy practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (855) 673-4325.

What is Dheeraj Boddi Reddy's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Dheeraj Boddi Reddy was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.