Individual provider Active NPI

Omar Mohammed Siddiqui, M.D.

  • Interventional Cardiology Physician
  • Cleveland, OH
National Provider Identifier
1467803122
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036149859 Issued in IL
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-7603
NPI assigned
Jun 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 036149859 IL Primary
Internal Medicine Physician 207R00000X 125069011 IL
Internal Medicine Physician 207R00000X 036149859 IL
Internal Medicine Physician 207R00000X 57248471 OH
Cardiovascular Disease Physician 207RC0000X 036149859 IL

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

460 Prince Valiant LN
Bourbonnais, IL 60914-9333
Phone (224) 619-2205

Other practice location 1

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NH, OH, IN, TN, TX, MI7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20220201001476 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3274820600 Reassigns benefits to 3 organizations
I20241122001504 NH Practitioner - Hospitalist 3274820600 Reassigns benefits to 1 organization
I20241210004079 OH Practitioner - Hospitalist 3274820600 Reassigns benefits to 1 organization
I20250125000008 IN Practitioner - Hospitalist 3274820600 Reassigns benefits to 1 organization
I20250211003870 TN Practitioner - Hospitalist 3274820600 Reassigns benefits to 1 organization
I20250313002253 TX Practitioner - Hospitalist 3274820600 Reassigns benefits to 1 organization
I20250417002662 MI Practitioner - Hospitalist 3274820600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians
Adventist Health Partners, Inc.Group PAC ID 0244135762, 253 clinicians

Practice addresses (Care Compare)

2200 N Section St
Sullivan, IN 47882-7523
Phone (972) 449-0540

2363 63Rd St
Woodridge, IL 60517-1369
Phone (630) 716-7510

3066 Valleybrook CT
Newburgh, IN 47630-2682
Phone (972) 449-0540

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting20
Leg revascularization (restoring blood flow)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125069011ILMDInternal Medicine Physician
57248471OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Illinois, LLC CurrentSince Jul 28, 2024 Accepting new patients
Specialty Physicians of Illinois, LLC Internal Medicine CurrentSince Jul 28, 2024 Accepting new patients
Siu Physicians & Surgeons, Inc Internal Medicine CurrentSince Jun 27, 2022 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jun 27, 2022 Accepting new patients

Locations

35318 Eagle Way
Chicago, IL 60678

3800 W 203rd St
Ste 204
Olympia Fields, IL 60461
Phone (708) 679-2670

3800 W 203rd St
Ste 202
Olympia Fields, IL 60461
Phone (708) 679-2010

3800 W 203rd St
Ste 201
Olympia Flds, IL 60461

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

701 N 1st St
Springfield, IL 62702
Phone (217) 545-0182

201 E Madison St
Ste 328
Springfield, IL 62702

201 E Madison St
Springfield, IL 62702
Phone (217) 545-1881

Interoperability endpoints

  • Direct secure messaging: osiddiqui141736@direct.luhs.org
  • Direct secure messaging: vrhosiddi@yourcarecommunity.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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1467803122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 PRINCE VALIANT LN",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609149333",
            "telephone_number": "224-619-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-7603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 N Rutledge St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627024968",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "OMAR",
        "middle_name": "MOHAMMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036149859",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125069011",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036149859",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57248471",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036149859",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.