Organization Active NPI

Alia Siddiqi,M.D,S.C

  • Specialist
  • Chicago, IL
National Provider Identifier
1659685873
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ALIA SIDDIQI,M.D,S.C
Doing business as
Alia Siddiqi,M.D,S.C
Practice address
4646 N Marine Dr Ste 5500a
Chicago, IL 60640-5759
Phone
(773) 561-1574
Fax
(773) 564-5829
NPI assigned
Jul 29, 2010
Last updated
Jul 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Dr. Alia Siddiqi, M.DNPI 1225148000
Title
President
Phone
(773) 561-1574

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

4646 N Marine Dr Ste 5500a
Chicago, IL 60640-5759

Mailing address

7017 N Kilbourn Ave
Lincolnwood, IL 60712-2216
Phone (847) 673-8459

Other identifiers 1

IdentifierTypeStateIssuer
036052692MedicaidIL

Other names 1

  • ALIA SIDDIQI,M.D,S.C Doing business as

National Provider Directory

National Provider Directory

Locations

4646 N Marine Dr
#5500A
Chicago, IL 60640
Phone (773) 561-1574

4646 N Marine Dr
Ste 5500A
Chicago, IL 60640
Phone (773) 561-1574

5310 N Sheridan Rd
#A
Chicago, IL 60640
Phone (773) 561-1574

5310 N Sheridan Rd
Ste A
Chicago, IL 60640
Phone (773) 561-1574

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1659685873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 N KILBOURN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122216",
            "telephone_number": "847-673-8459",
            "fax_number": "773-564-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR STE 5500A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-561-1574",
            "fax_number": "773-564-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIA SIDDIQI,M.D,S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "ALIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-561-1574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052692",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALIA SIDDIQI,M.D,S.C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 29, 2010; 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.