Individual provider Active NPI

Hisham M Siddiqui, MD

  • Hospitalist Physician
  • Glenview, IL
National Provider Identifier
1689023897
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036148588 Issued in IL
Practice address
2100 Pfingsten Rd Ste 3001a
Glenview, IL 60026
Phone
(847) 657-5840
Fax
(847) 657-5732
NPI assigned
Jun 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 57.030487 OH
Internal Medicine Physician 207R00000X 036148588 IL
Student in an Organized Health Care Education/Training Program 390200000X 125068040 IL
Hospitalist Physician 208M00000X 036148588 IL Primary

Addresses

Primary practice location

2100 Pfingsten Rd Ste 3001a
Glenview, IL 60026

Mailing address

2100 Pfingsten Rd Ste 3001a
Glenview, IL 60026-1301
Phone (847) 657-5840

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Other practice location 2

1701 Curtis Rd
Champaign, IL 61822-9678
Phone (217) 365-6207

Other practice location 3

777 Park Ave. West
IM Hospitalists
Highland Park, IL 60035
Phone (847) 926-5840

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
I20190515002084 IL Practitioner - HospitalistPractitioner - Internal Medicine 8820331879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-5197

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036148588ILMDHospitalist Physician
125068040ILMDStudent in an Organized Health Care Education/Training Program
57.030487OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jul 1, 2019 Accepting new patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
University of Chicago Past Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2100 Pfingsten Rd
Ste 3001A
Glenview, IL 60026
Phone (847) 570-1010

777 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3744

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1689023897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD STE 3001A",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "847-657-5840",
            "fax_number": "847-657-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD STE 3001A",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "847-657-5840",
            "fax_number": "847-657-5732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618229678",
            "country_code": "US",
            "telephone_number": "217-365-6207",
            "fax_number": "217-365-6378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Park Ave. West",
            "address_2": "IM Hospitalists",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "IL",
            "postal_code": "60035",
            "country_code": "US",
            "telephone_number": "847-926-5840",
            "fax_number": "847-733-5108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "HISHAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.030487",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036148588",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125068040",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036148588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.