Individual provider Active NPI

Dilraj Singh Sidhu, M.D.

  • Internal Medicine Physician
  • Grayslake, IL
National Provider Identifier
1811953722
Registry record updated Jan 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42662020 Issued in WI
Practice address
480 S US Highway 45
Abbvie
Grayslake, IL 60030-3910
Phone
(847) 935-4326
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42662020 WI Primary

Addresses

Primary practice location

480 S US Highway 45
Abbvie
Grayslake, IL 60030-3910

Mailing address

7550 S Cambridge Dr
Franklin, WI 53132-8253
Phone (414) 425-5010

Other identifiers 1

IdentifierTypeStateIssuer
34051700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42662020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Past Accepting new patients
Cogent Healthcare of Wisconsin, SC Internal Medicine Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483747200000",
    "number": "1811953722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 S CAMBRIDGE DR",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531328253",
            "telephone_number": "414-425-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 S US HIGHWAY 45",
            "address_2": "ABBVIE",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600303910",
            "telephone_number": "847-935-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "DILRAJ",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2017-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "42662020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34051700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2017; 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.