Individual provider Active NPI

Safia Siddiqui, DO

  • Family Medicine Physician
  • Lombard, IL
National Provider Identifier
1891361846
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.171084 Issued in IL
Practice address
454 E Roosevelt Rd
Lombard, IL 60148-4630
Phone
(630) 387-6424
Fax
(630) 387-6425
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5151015034 MI
Family Medicine Physician 207Q00000X 036.171084 IL Primary

Addresses

Primary practice location

454 E Roosevelt Rd
Lombard, IL 60148-4630

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5985

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address ssiddiqui407095@direct.myadvocateaurora.org Direct

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
I20240904002485 IL Practitioner - Family Practice 3072918010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

454 E Roosevelt Rd
Lombard, IL 60148-4630
Phone (630) 387-6424

Hospital & facility affiliations

  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.171084ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 11, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 11, 2024 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

454 E Roosevelt Rd
Lombard, IL 60148
Phone (630) 387-6424

Interoperability endpoints

  • Direct secure messaging: ssiddiqui407095@direct.myadvocateaurora.org

Organizations & group practices 2

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1891361846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 E ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484630",
            "telephone_number": "630-387-6424",
            "fax_number": "630-387-6425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Genesys Pkwy",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484398065",
            "country_code": "US",
            "telephone_number": "810-606-5985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SAFIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151015034",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.171084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "454 E Roosevelt Rd",
            "city": "Lombard",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601484630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssiddiqui407095@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "454 E Roosevelt Rd",
            "city": "Lombard",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601484630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.