Active NPI
Anum Siddiqui, DDS
- General Practice Dentistry
- Oswego, IL
National Provider Identifier
1649955162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.034356
- Practice address
- 1301 Orchard Rd
Oswego, IL 60543-5013 - Phone
- (630) 882-3426
- NPI assigned
- Jun 21, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.034356 | IL | Primary |
Addresses
Primary practice location
1301 Orchard Rd
Oswego, IL 60543-5013
Mailing address
925 Jenna CT
Glen Ellyn, IL 60137-6406
Phone (920) 791-9243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.034356 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1649955162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 JENNA CT",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601376406",
"telephone_number": "920-791-9243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 ORCHARD RD",
"city": "OSWEGO",
"state": "IL",
"postal_code": "605435013",
"telephone_number": "630-882-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDDIQUI",
"first_name": "ANUM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-21",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.034356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oswego, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.