Reshma Banu Siddotam, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070023126 Issued in IL

Practice address

1110 Cedar CT
Carbondale, IL 62901-5300

Phone

(618) 529-4360

Fax

(618) 529-4560

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1609393446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 TESTA DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015300",
            "telephone_number": "618-529-4360",
            "fax_number": "618-529-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDOTAM",
        "first_name": "RESHMA BANU",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Socorro J Shelton, MD
• Keni Sherrell, LPN
• Daniel Sherwood, PA
• Roger Sebastian Shinnerl, M.D.
• Jennifer Marie Shopinski, APN, CNM, IBCLC
• Jennifer A Siegel, MD
• Amal Sieny, LCSW
• Ricardo Andres Siller de la Rosa, MD
• Ro-Kaye Alethea Simmonds, MBBS
• Rosemary Elizabeth Simmons, PH.D.

• Physical Therapist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.