Individual provider Active NPI

Shan H Siddiqi, MD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1285075887
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036150923 Issued in IL
Practice address
676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954
Phone
(312) 695-5060
Fax
(312) 695-5010
NPI assigned
Jul 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2013023204 MO
Psychiatry Physician 2084P0800X 036150923 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954

Mailing address

660 S Euclid Ave
Saint Louis, MO 63110-1010

Other practice location 1

1180 N Indian Canyon Dr Ste E421
Palm Springs, CA 92262-4882
Phone (760) 424-8224

Other practice location 2

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-6753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180220000963 MA Practitioner - Psychiatry 3577824358 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013023204MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Psychiatry CurrentSince Jul 1, 2018 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jul 1, 2020 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 7, 2019 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
First Choice Physician Partners CurrentSince Aug 17, 2023 Accepting new patients
Dupage Psychiatric Care PLLC Psychiatry CurrentSince Aug 1, 2026 Accepting new patients
First Choice Physician Partners CurrentSince Aug 17, 2023 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Dec 20, 2017 Accepting new patients
First Choice Physician Partners Current Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 7, 2019 Accepting new patients

Locations

1180 N Indian Canyon Dr
Ste E421
Palm Springs, CA 92262
Phone (760) 424-8224

35800 Bob Hope Dr
Ste 225
Rancho Mirage, CA 92270
Phone (760) 324-4466

1737 S Naperville Rd
Ste 203
Wheaton, IL 60189
Phone (630) 344-5150

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Interoperability endpoints

  • Direct secure messaging: siddiqi.shan.bwh@direct.partners.masshiway.net

Organizations & group practices 10

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1285075887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112954",
            "telephone_number": "312-695-5060",
            "fax_number": "312-695-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1180 N Indian Canyon Dr Ste E421",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624882",
            "country_code": "US",
            "telephone_number": "760-424-8224",
            "fax_number": "760-422-3155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-6753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "SHAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2013023204",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036150923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.