Jehanzab A Siddiqui, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016.005767 Issued in IL

Practice address

10002 S Kedzie Ave
Evergreen Park, IL 60805-3420

Phone

(847) 390-7666

Fax

(847) 390-9345

NPI assigned

Apr 22, 2016

Last updated

Jan 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weil Foot and Ankle Institute LLCGroup PAC ID 4587655105, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Weil Foot and Ankle Institute LLC

  • Foot & Ankle Surgery Podiatrist
  • Mount Prospect, IL
  • NPI 1710965314
  Medicare reassignment Care Compare group NPD
• Alpine Foot Specialists, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Lake Zurich, IL
  • NPI 1720728876
  Medicare reassignment NPD
• Weil Foot and Ankle Institute LLC

  • Clinical Medical Laboratory
  • Mount Prospect, IL
  • NPI 1154942837
  NPD
• Weil Foot and Ankle Institute LLC

  • Podiatrist
  • Chicago, IL
  • NPI 1992678312

  Foot & Ankle Surgery

  NPD
• Weil Foot & Ankle Institute

  • Foot Surgery Podiatrist
  • Des Plaines, IL
  • NPI 1821097262
  NPD (past)

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

• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  dba Advocate Christ Medical Center

  • General Acute Care Hospital
  • Oak Lawn, IL
  • NPI 1548375082
  Care Compare affiliation

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1508210808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 FEEHANVILLE DR STE 450",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600566023",
            "telephone_number": "847-390-7666",
            "fax_number": "847-390-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10002 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053420",
            "telephone_number": "847-390-7666",
            "fax_number": "847-390-9345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10255 Southwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Chicago Ridge",
            "state": "IL",
            "postal_code": "604151350",
            "country_code": "US",
            "telephone_number": "847-390-7666",
            "fax_number": "847-390-9345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "JEHANZAB",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001316A",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://balancehealth.com/provider/jehanzab-siddiqui-dpm/weil-foot-and-ankle-institute/",
            "affiliation": "Y",
            "endpointDescription": "Appointments",
            "affiliationName": "Weil Foot and Ankle Institute LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1660 Feehanville Dr Ste 450",
            "city": "Mount Prospect",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600566023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jehanzab.siddiqui@weil4feet.com",
            "affiliation": "Y",
            "affiliationName": "Weil Foot and Ankle Institute LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1660 Feehanville Dr Ste 100",
            "city": "Mount Prospect",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suman Kant Setia, M.D.
• Prabodh C Shah, M.D.
• Vishakha Shah, PT
• David Shapiro, M.D.
• Kara Michele Sharp, M.S.
• Roberto Luis Siller, MOTR/L
• Simply Wounds and Lymphatics, PLLC
• Gurpreet Singh, APRN
• Heather Singler, PT, DPT
• Donna T Skinner, FNP

• Foot & Ankle Surgery Podiatrist in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.