Ahmed Faraz Siddiqui, D.O.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036148488 Issued in IL

Practice address

1426 W Washington Blvd
Chicago, IL 60607-1821

Phone

(312) 829-1424

NPI assigned

Apr 25, 2016

Last updated

Jul 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Kidney Specialists of Illinois, LLCGroup PAC ID 9931339546, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CGH Medical Center Hospital, Sterling, IL, CCN 140043
• Morrison Community Hospital Hospital, Morrison, IL, CCN 141329

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahmed.siddiqui@mmhealth.cernerdirect.com
• Direct secure messaging: asiddiqui@yourcarecommunity.org
• Direct secure messaging: asiddiqui19314@cghmc.direct-ci.com
• Direct secure messaging: asiddiqui2093655@nychhc.direct-ci.com

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.

• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Medicare reassignment Care Compare group NPD
• Kidney Specialists of Illinois LLC

  • Nephrology Physician
  • Chicago, IL
  • NPI 1275969222
  Medicare reassignment Care Compare group NPD
• CGH Medical Center

  dba CGH Medical Center-Morrison

  • Durable Medical Equipment & Medical Supplies
  • Morrison, IL
  • NPI 1447415724
  NPD
• Margaret Mary Community Hospital, Inc

  • Internal Medicine Physician
  • Batesville, IN
  • NPI 1316118730
  NPD
• Rural Physicians Group-Pannu PLLC

  • Hospitalist Physician
  • Greenwood Village, CO
  • NPI 1861808719

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Care Compare affiliation
• Morrison Community Hospital District

  • Critical Access Hospital
  • Morrison, IL
  • NPI 1184844938
  Care Compare affiliation

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1235584541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 W WASHINGTON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071821",
            "telephone_number": "312-829-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 W WASHINGTON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071821",
            "telephone_number": "312-829-1424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5019 Coyle Ave",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600773517",
            "country_code": "US",
            "telephone_number": "312-576-1825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "AHMED",
        "middle_name": "FARAZ",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02005873A",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036148488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nuha Fatimah Siddiqi
• Shan H Siddiqi, MD
• Labiba Siddique
• Shan Siddique
• Teepu Siddique, MD
• Aisha Siddiqui, DO
• Amir Siddiqui, DO
• Annie Nasir Siddiqui, DPM
• Faiza Siddiqui, MD
• Faiza Qaiser Siddiqui, M.D.

• Nephrology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.