Irshad Ahmed Siddique, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

Practice address

400 N Division St
Harvard, IL 60033-3061

Phone

(815) 943-7709

Fax

(847) 931-7726

NPI assigned

Aug 15, 2005

Reactivated

Mar 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• McLean Foot Clinic,P.C.

  • Podiatrist
  • Harvard, IL
  • NPI 1760437602
  Medicare reassignment NPD Authorized official
• McLean Foot Clinic PC

  • Podiatric Clinic/Center
  • Elgin, IL
  • NPI 1952615114
  NPD Authorized official

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1700888187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N DIVISION ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600333061",
            "telephone_number": "815-943-7709",
            "fax_number": "847-931-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N DIVISION ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600333061",
            "telephone_number": "815-943-7709",
            "fax_number": "847-931-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "IRSHAD",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-11-12",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0005632037",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela K Rees, OT
• Rehab Management Specialists, PC
• Kristen L Rezac
• Diane M. Rogers, PSY.D.
• Karen Lydia Shilvock-Cinefro, LSW, NHA
• Isaih Solis
• Hallie Kristina Stabla, COTA
• Elizabeth Anne Steffens, NP-C
• Elizabeth A Sukowicz, PH.D.
• James H Sullivan, MD

• Podiatrist in Harvard, IL
• Providers in Harvard, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.