Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 036-125910 | IL |
NPI | 1013110816 |
---|---|
Provider Name | Dr. Saad Ahmed Siddiqui |
First Address | Oak Lawn, IL 60453-2600 |
Second Address | Kalamazoo, MI 49008-1282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 13/05/2021 |