Individual provider Active NPI

Zaki A Siddiqui, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1366534729
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036100955 Issued in IL
Practice address
2515 W Lawrence Ave
Chicago, IL 60625-3679
Phone
(773) 989-3344
Fax
(773) 989-8458
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036100955 IL Primary

Addresses

Primary practice location

2515 W Lawrence Ave
Chicago, IL 60625-3679

Mailing address

2515 W Lawrence Ave
Chicago, IL 60625-3679
Phone (773) 989-3344

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
I20080702000684 IL Practitioner - Pediatric Medicine 8123190394 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036100955ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Center for Pain Control LLC CurrentSince Jun 29, 2022 Accepting new patients
Omni Health PC Pediatrics Past Accepting new patients
Omni Health PC Pediatrics Past Accepting new patients

Locations

6501 N Lincoln Ave
Lincolnwood, IL 60712
Phone (847) 242-1001

Organizations & group practices 4

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1366534729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253679",
            "telephone_number": "773-989-3344",
            "fax_number": "773-989-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253679",
            "telephone_number": "773-989-3344",
            "fax_number": "773-989-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ZAKI",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036100955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.