Individual provider Active NPI

Syed Saaduddin, M.D.

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1316986920
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036-081114 Issued in IL
Practice address
401 E 61St St
S&F Medical Center
Chicago, IL 60637-2324
Phone
(773) 955-5560
Fax
(773) 955-5580
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 036-081114 IL Primary

Addresses

Primary practice location

401 E 61St St
S&F Medical Center
Chicago, IL 60637-2324

Mailing address

3 115TH St
Lemont, IL 60439-8753
Phone (630) 789-6455

Other identifiers 2

IdentifierTypeStateIssuer
0031604575OtherILBLUE CROSS BLUE SHIELD IL
036081114MedicaidIL

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
I20100611000667 IL Practitioner - Internal Medicine 5799815049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

401 E 61St St
Chicago, IL 60637-2324
Phone (773) 955-5560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-081114ILMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pilsen-Little Village Community Mental Health Center, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Syed Saaduddin MD SC General Practice CurrentSince Apr 3, 2010 Accepting new patients
Advocate North Side Health Network Past Accepting new patients

Locations

401 E 61st St
Chicago, IL 60637
Phone (773) 667-4400

Organizations & group practices 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1316986920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 115TH ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604398753",
            "telephone_number": "630-789-6455",
            "fax_number": "773-955-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 61ST ST",
            "address_2": "S&F MEDICAL CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372324",
            "telephone_number": "773-955-5560",
            "fax_number": "773-955-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAADUDDIN",
        "first_name": "SYED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036-081114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "0031604575",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081114",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.