Individual provider Active NPI

Hina Siddiqui, D.O.

  • Hospitalist Physician
  • St Charles, IL
National Provider Identifier
1265895247
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036148796 Issued in IL
Practice address
3755 E Main St Ste 190
St Charles, IL 60174-2463
Phone
(630) 348-3100
Fax
(630) 513-0727
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.148796 IL
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 036148796 IL Primary

Addresses

Primary practice location

3755 E Main St Ste 190
St Charles, IL 60174-2463

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-3328
Phone (630) 469-9200

Other practice location 1

2650 Ridge Ave # 1223
Evanston, IL 60201-1700
Phone (847) 982-3172

Other practice location 2

1675 Dempster St Fl 1
Park Ridge, IL 60068-1110
Phone (847) 318-9300

Other practice location 3

4440 W 95th St Ste 2177H
Oak Lawn, IL 60453-2600
Phone (708) 684-5341

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address hsiddiqui227767@direct.edward.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address hsiddiqui380876@direct.myadvocateaurora.org Direct

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
I20230607000181 IL Practitioner - HospitalistPractitioner - Pediatric Medicine 9931566924 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.148796ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corp. CurrentSince Aug 25, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince May 25, 2023 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 25, 2023 Accepting new patients
Endeavor Health Medical Group Pediatrics Current Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Dupage Medical Group LTD PastSince Jun 22, 2021 Accepting new patients
Dupage Medical Group LTD PastSince Jun 22, 2021 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

4440 W 95th St
Ste 2177H
Oak Lawn, IL 60453
Phone (708) 684-5341

1675 W Dempster St
Fl 1
Park Ridge, IL 60068
Phone (847) 318-9300

Interoperability endpoints

  • Direct secure messaging: hsiddiqui227767@direct.edward.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1265895247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606743328",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 E MAIN ST STE 190",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742463",
            "telephone_number": "630-348-3100",
            "fax_number": "630-513-0727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave # 1223",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011700",
            "country_code": "US",
            "telephone_number": "847-982-3172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1675 Dempster St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681110",
            "country_code": "US",
            "telephone_number": "847-318-9300",
            "fax_number": "847-723-9583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4440 W 95th St Ste 2177H",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532600",
            "country_code": "US",
            "telephone_number": "708-684-5341",
            "fax_number": "708-684-4716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "HINA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.148796",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036148796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsiddiqui227767@direct.edward.org",
            "affiliation": "N",
            "address_1": "3755 E Main St Ste 190",
            "city": "St Charles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601742463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1675 Dempster St Fl 1",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsiddiqui380876@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1675 Dempster St Fl 1",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.