Individual provider Active NPI

Mahrukh Siddiqui, MD

  • Internal Medicine Physician
  • South Elgin, IL
National Provider Identifier
1205316908
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036153913 Issued in IL
Practice address
552 Randall Rd
South Elgin, IL 60177-3315
Phone
(630) 315-6700
Fax
(630) 315-6699
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036153913 IL Primary
Internal Medicine Physician 207R00000X 125.072841 IL

Addresses

Primary practice location

552 Randall Rd
South Elgin, IL 60177-3315

Mailing address

552 Randall Rd
South Elgin, IL 60177-3315
Phone (630) 315-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818003066 IL Order and Referring Only - Family PracticePractitioner - Family Practice 2961885231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036153913ILMDInternal Medicine Physician
125.072841ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Aug 1, 2026 Accepting new patients
Central Dupage Physician Group PastSince Aug 1, 2026 Accepting new patients

Locations

552 Randall Rd
South Elgin, IL 60177
Phone (630) 315-6700

Interoperability endpoints

  • Direct secure messaging: mahrukh.siddiqui.p1@direct.gefcc.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1205316908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 RANDALL RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773315",
            "telephone_number": "630-315-6700",
            "fax_number": "630-315-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 RANDALL RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773315",
            "telephone_number": "630-315-6700",
            "fax_number": "630-315-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MAHRUKH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036153913",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.072841",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

Verify at the official NPI Registry.