Individual provider Active NPI

Nadeem Siddiqui, MD

  • Gastroenterology Physician
  • McHenry, IL
National Provider Identifier
1770577785
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036175750 Issued in IL
Practice address
4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417
Phone
(847) 535-6083
Fax
(815) 455-2789
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35007 WI
Gastroenterology Physician 207RG0100X 036175750 IL Primary

Addresses

Primary practice location

4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Other practice location 2

2700 E Enterprise Ave,
Unit C
Appleton, WI 54913
Phone (920) 738-7300

Other identifiers 1

IdentifierTypeStateIssuer
33328600MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nsiddiqui354939@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061018000040 WI Practitioner - Gastroenterology 6507862315 Reassigns benefits to 4 organizations
I20250714000575 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 6507862315

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 923-7400

Hospital & facility affiliations

  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Upper gastrointestinal (GI) endoscopy for acid reflux31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35007WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 25, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 25, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Feb 3, 2022 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince Jun 27, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Feb 3, 2022 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jan 13, 2025 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jan 13, 2025 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc PastSince Mar 19, 2023 Accepting new patients

Locations

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

Interoperability endpoints

  • Direct secure messaging: nsiddiqui528749@direct-ehr-ssmhc.com

Organizations & group practices 10

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 2

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": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1770577785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B202",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508417",
            "telephone_number": "847-535-6083",
            "fax_number": "815-455-2789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549047668",
            "country_code": "US",
            "telephone_number": "920-303-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 E ENTERPRISE AVE,",
            "address_2": "UNIT C",
            "address_purpose": "LOCATION",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "country_code": "US",
            "telephone_number": "920-738-7300",
            "fax_number": "920-738-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "NADEEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "35007",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036175750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33328600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsiddiqui354939@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.