Individual provider Active NPI

Mohammed S. Siddiqui, MD

  • Geriatric Psychiatry Physician
  • Lombard, IL
National Provider Identifier
1639456122
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
036-131386 Issued in IL
Practice address
477 E Butterfield Rd Ste 102
Lombard, IL 60148-4880
Phone
(630) 528-3835
Fax
(630) 528-3837
NPI assigned
Nov 10, 2011
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 036-131386 IL Primary

Addresses

Primary practice location

477 E Butterfield Rd Ste 102
Lombard, IL 60148-4880

Mailing address

477 E Butterfield Rd Ste 102
Lombard, IL 60148-4880
Phone (630) 528-3835

Other identifiers 1

IdentifierTypeStateIssuer
036131386MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130417000630 IL Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 8729224720 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100

1400 W Park St
Urbana, IL 61801-2334
Phone (217) 337-2000

1725 W Harrison St
Suite 955
Chicago, IL 60612-3862
Phone (312) 942-7030

2625 Butterfield Rd
Suite 138S
Oak Brook, IL 60523-1244
Phone (630) 290-2246

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-131386ILMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Aug 1, 2023 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Feb 1, 2013 Accepting new patients
Rush University Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Edward Health Ventures CurrentSince Jul 1, 2013 Accepting new patients
Ottawa Regional Hospital & Healthcare Center Psychiatry CurrentSince May 17, 2022 Accepting new patients
Midwest Functional Psychiatry Psychiatry Current Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Feb 13, 2018 Accepting new patients
City of Hope Medical Group of Illinois PLLC CurrentSince Aug 20, 2019 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince May 17, 2022 Accepting new patients
Siu Physicians & Surgeons, Inc Psychiatry CurrentSince Feb 1, 2013 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Feb 13, 2018 Accepting new patients
St. Mary's Hospital, Centralia, Illinois Current Accepting new patients
S S Behavioral Health Inc Psychiatry CurrentSince Aug 25, 2017 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Mar 30, 2018 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jul 1, 2018 Accepting new patients
Edward Health Ventures CurrentSince Jul 1, 2013 Accepting new patients
Edward Health Ventures Past Accepting new patients

Locations

20733 N Broad St
Carlinville, IL 62626
Phone (217) 854-3141

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

444 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5665

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 955
Chicago, IL 60612
Phone (312) 563-3700

2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

75 Remittance Dr
Dept 1611
Chicago, IL 60675

477 E Butterfield Rd
Ste 102
Lombard, IL 60148
Phone (630) 424-8900

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

120 Spalding Dr
Ste 307
Naperville, IL 60540
Phone (630) 355-1102

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

2625 Butterfield Rd
Ste 138S
Oak Brook, IL 60523
Phone (630) 290-2246

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

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

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1639456122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 E BUTTERFIELD RD STE 102",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484880",
            "telephone_number": "630-528-3835",
            "fax_number": "630-528-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 E BUTTERFIELD RD STE 102",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484880",
            "telephone_number": "630-528-3835",
            "fax_number": "630-528-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MOHAMMED",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-10",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "IL",
            "license": "036-131386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036131386",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.