Individual provider Active NPI

Farah Siddique, NP-C

  • Family Nurse Practitioner
  • Schaumburg, IL
National Provider Identifier
1417639501
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07230564 Issued in IL
Practice address
1355 Remington Rd
Schaumburg, IL 60173-4832
Phone
(872) 710-5116
NPI assigned
Aug 7, 2023
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07230564 IL Primary

Addresses

Primary practice location

1355 Remington Rd
Schaumburg, IL 60173-4832

Mailing address

308 Capulina CT
Morton Grove, IL 60053-3111
Phone (847) 778-1325

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000249 IL Practitioner - Nurse Practitioner 1951759364 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2443 Warrenville Rd
Suite 500
Lisle, IL 60532-4356
Phone (855) 902-5100

4215 S State Route 159
Glen Carbon, IL 62034-3267
Phone (800) 358-8227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F07230564ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Residential Hospice of Southern Illinois, LLC CurrentSince Nov 22, 2024 Accepting new patients
Residential Hospice Illinois, LLC CurrentSince Oct 15, 2023 Accepting new patients
Residential Hospice of Southern Illinois, LLC CurrentSince Nov 22, 2024 Accepting new patients
Residential Hospice Illinois, LLC CurrentSince Oct 15, 2023 Accepting new patients

Locations

4215 S State Route 159
Glen Carbon, IL 62034
Phone (800) 358-8227

2443 Warrenville Rd
Ste 500
Lisle, IL 60532
Phone (844) 275-4430

104 Airway Dr
Ste 1
Marion, IL 62959
Phone (800) 358-8227

630 Dundee Rd
Ste 320
Northbrook, IL 60062
Phone (866) 902-0123

5440 Corporate Dr
Ste 400
Troy, MI 48098
Phone (866) 902-5854

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1417639501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CAPULINA CT",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533111",
            "telephone_number": "847-778-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 REMINGTON RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734832",
            "telephone_number": "872-710-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "FARAH",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "F07230564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.