Siad Mohammed Adam, M.D

Individual provider Active NPI Internal Medicine Physician · McHenry, IL

NPI 1093569774 · NPPES record last updated Aug 1, 2024

Key facts

NPI
1093569774
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
125.085005 (IL)
Practice address
4201 Medical Center Drive
McHenry, IL 60050
Phone
(815) 344-5000
NPI assigned
Apr 17, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241009000800 IL Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
6406387828

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 125.085005 IL Yes

Addresses

Primary practice location

4201 Medical Center Drive
McHenry, IL 60050

Mailing address

4201 Medical Center Drive
McHenry, IL 60050
Phone (815) 344-5000

Other providers in McHenry, IL

All providers in McHenry, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.