Active NPI
Majid Nasir Siddiqi
- Certified Registered Nurse Anesthetist
- Avon, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209.028872
- Practice address
- 808 Flying Sun Dr
Avon, IN 46123-9848 - Phone
- (317) 658-6406
- NPI assigned
- Apr 26, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Certified Registered Nurse Anesthetist | 367500000X | 209.028872 | IL | Primary |
Addresses
Primary practice location
808 Flying Sun Dr
Avon, IN 46123-9848
Mailing address
808 Flying Sun Dr
Avon, IN 46123-9848
Other practice location 1
1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-2210
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2650 Ridge Ave
Evanston, IL 60201-1700
333 Madison St
Joliet, IL 60435-8200
Phone (815) 725-7133
800 W Central Rd
Arlington Heights, IL 60005-2349
Phone (847) 618-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.028872 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Northstar Anesthesia of Illinois, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| North American Partners in Anesthesia (Illinois), LLC | Current | Accepting new patients | |
| Endeavor Health Medical Group | Current | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175
333 Madison St
Joliet, IL 60435
Phone (815) 725-7222
1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1962822395
IL, Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1578932869
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1770531600
-
- General Acute Care Hospital
- Joliet, IL
- NPI 1760220198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1114615374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 FLYING SUN DR",
"city": "AVON",
"state": "IN",
"postal_code": "461239848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 FLYING SUN DR",
"city": "AVON",
"state": "IN",
"postal_code": "461239848",
"telephone_number": "317-658-6406"
}
],
"practiceLocations": [
{
"address_1": "1775 Dempster St",
"address_purpose": "LOCATION",
"city": "Park Ridge",
"state": "IL",
"postal_code": "600681143",
"country_code": "US",
"telephone_number": "847-723-2210",
"fax_number": "847-723-3532",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NASIR SIDDIQI",
"first_name": "MAJID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-26",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209.028872",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1775 Dempster St",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681143",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.