Mohammad Tabraize Siddique
Geriatric Medicine
6101 S County Line Rd
Burr Ridge
, Illinois 60527-8132
Mohammad Tabraize Siddique
Geriatric Medicine
6101 S County Line Rd
Burr Ridge
, Illinois 60527-8132
(630) 469-2000
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Mohammad Tabraize Siddique
- 1860 Paysphere Cir
- Chicago, IL
- Zip : 60674-8132
- Phone : (630) 469-2000
Second Address
- Mohammad Tabraize Siddique
- 6101 S County Line Rd
- Burr Ridge, IL
- Zip : 60527-8132
- Fax : (844) 235-2578
- Phone : (630) 686-9000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 036117676 | IL |
National Provider Identifier
| NPI | 1144439456 |
|---|---|
| Provider Name | Mohammad Tabraize Siddique |
| First Address | Chicago, IL 60674-8132 |
| Second Address | Burr Ridge, IL 60527-8132 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/05/2007 |
| Last Update Date | 26/07/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| F100323989 | GROUP MEDICARE PTAN (01) | IL |
| I45155 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.