Individual provider Active NPI

Dareen D Siri, M.D.

  • Allergy & Immunology (Internal Medicine) Physician
  • Normal, IL
National Provider Identifier
1730272998
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
License
036-113138 Issued in IL
Practice address
2010 Jacobssen Dr
Normal, IL 61761-6280
Phone
(309) 452-0995
Fax
(309) 862-0961
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 036-113138 IL Primary

Addresses

Primary practice location

2010 Jacobssen Dr
Normal, IL 61761-6280

Mailing address

2010 Jacobssen Dr
Normal, IL 61761-6280
Phone (309) 452-0995

Other identifiers 3

IdentifierTypeStateIssuer
204961014OtherILMEDICARE PTAN
036113138MedicaidIL
F100118284OtherILPTAN

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
I20050411000804 IL Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 8325085434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Un of California, Irvine, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Allergy Sinus Asthma SCGroup PAC ID 3870722283, 9 clinicians
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

2010 Jacobssen Dr
Normal, IL 61761-6280
Phone (309) 452-0995

720 N Bond St
Springfield, IL 62702-4952
Phone (217) 545-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-113138ILMDAllergy & Immunology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc Allergy & Immunology CurrentSince Jul 18, 2022 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 18, 2022 Accepting new patients
Midwest Allergy Sinus Asthma S.C. CurrentSince Dec 22, 2013 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

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

1745 W Walnut St
Jacksonville, IL 62650
Phone (217) 243-6454

2010 Jacobssen Dr
Normal, IL 61761
Phone (309) 452-0995

2151 W White Oaks Dr
Springfield, IL 62704
Phone (217) 361-6254

720 N Bond St
Springfield, IL 62702
Phone (217) 545-4777

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9233/brand/1/csg/1/fhir/r4
  • Direct secure messaging: dareensiri@siusm.allscriptsdirect.net

Organizations & group practices 5

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 1

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1730272998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616280",
            "telephone_number": "309-452-0995",
            "fax_number": "309-862-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616280",
            "telephone_number": "309-452-0995",
            "fax_number": "309-862-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRI",
        "first_name": "DAREEN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "IL",
            "license": "036-113138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "204961014",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036113138",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "F100118284",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.