Individual provider Active NPI

Sarah Nazeer Siddiqui, D.O.

  • Internal Medicine Physician
  • La Grange Highlands, IL
National Provider Identifier
1982847026
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.124438 Issued in IL
Practice address
5201 Willow Springs Rd Ste 160
La Grange Highlands, IL 60525-6558
Phone
(708) 245-8120
NPI assigned
Apr 17, 2009
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 036.124438 IL Primary

Addresses

Primary practice location

5201 Willow Springs Rd Ste 160
La Grange Highlands, IL 60525-6558

Mailing address

5201 Willow Springs Rd Ste 160
La Grange Highlands, IL 60525-6558
Phone (708) 245-8120

Other practice location 1

6723 Roosevelt Rd
Berwyn, IL 60402-1007
Phone (708) 383-6333

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sarah.siddiqui.1@380.direct.athenahealth.com

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
I20101112001000 IL Practitioner - Internal Medicine 8729273990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventist Health Partners, Inc.Group PAC ID 0244135762, 253 clinicians

Practice addresses (Care Compare)

396 Remington Blvd
Bolingbrook, IL 60440-4311

630 E N Ave
Carol Stream, IL 60188-2127
Phone (630) 458-5300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.124438ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Partners,Inc CurrentSince Jun 11, 2013 Accepting new patients
Adventist Health Partners, Inc. CurrentSince Jun 11, 2013 Accepting new patients
Adventist Health Partners, Inc. Current Accepting new patients
Adventist Health Partners,Inc Past Accepting new patients
24 Ihim LLC Internal Medicine PastSince Jul 25, 2019 Accepting new patients
Adventist Health Partners, Inc Past Accepting new patients
Holy Cross Hospital Internal Medicine Past Accepting new patients

Locations

6723 Roosevelt Rd
Berwyn, IL 60402
Phone (708) 383-6333

396 Remington Blvd
Ste 231
Bolingbrook, IL 60440
Phone (630) 312-4301

701 Winthrop Ave
Glendale Hts, IL 60139
Phone (630) 312-2000

911 N Elm St
Ste 123
Hinsdale, IL 60521
Phone (630) 325-5709

5201 Willow Springs Rd
Ste 150
La Grange Highlands, IL 60525
Phone (630) 789-9093

5201 Willow Springs Rd
Ste 160
La Grange Highlands, IL 60525
Phone (708) 245-8120

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

Interoperability endpoints

  • Direct secure messaging: sarah.siddiqui.1@26824.direct.athenahealth.com
  • Direct secure messaging: sarah.siddiqui.1@380.direct.athenahealth.com
  • Direct secure messaging: ssiddiqui1241168@adventhealth.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1982847026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD STE 160",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256558",
            "telephone_number": "708-245-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD STE 160",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256558",
            "telephone_number": "708-245-8120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6723 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604021007",
            "country_code": "US",
            "telephone_number": "708-383-6333",
            "fax_number": "708-383-6347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SARAH",
        "middle_name": "NAZEER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.124438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarah.siddiqui.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "5201 Willow Springs Rd Ste 160",
            "city": "LA Grange Highlands",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605256558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Grange Highlands, IL

Sources for this page

Verify at the official NPI Registry.