Active NPI
Mohammed Abdul Khadar Siddiqui, DO
- Pediatrics Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036161338
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1443 - Phone
- (888) 824-0200
- NPI assigned
- Mar 28, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036161338 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Chicago Medical Center | Current | Accepting new patients | |
| SSM Health Care St Louis | Current | Accepting new patients | |
| SSM Health Care St. Louis | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| Pcrmc Medical Group, Inc | Pediatrics | Current | Accepting new patients |
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current | Accepting new patients |
| University of Chicago | Current | Accepting new patients | |
| SSM Cardinal Glennon Children'S Hospital | Pediatrics | Current | Accepting new patients |
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
1465 S Grand Blvd
Rm 2712
Saint Louis, MO 63104
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
13000 Butler Crest Dr
Saint Louis, MO 63128
Phone (314) 842-3535
232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030
Interoperability endpoints
- msiddiqui328247@uchospital.direct-ci.com
Organizations & group practices 9
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1821048786
-
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
-
- Pediatrics Physician
- Warrenton, MO
- NPI 1962573212
-
- Cardiovascular Disease Physician
- Bridgeton, MO
- NPI 1376598599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1508228669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 HARVESTER DR STE 300",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605275965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371443",
"telephone_number": "888-824-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDDIQUI",
"first_name": "MOHAMMED",
"middle_name": "ABDUL KHADAR",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-28",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036161338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.