Healthcare Provider Details

I. General information

NPI: 1982285540
Provider Name (Legal Business Name): AMANULLAH SIDDIQUI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 SPRINGBROOK SQUARE DR
NAPERVILLE IL
60564-5963
US

IV. Provider business mailing address

1924 SPRINGBROOK SQUARE DR
NAPERVILLE IL
60564-5963
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-9950
  • Fax:
Mailing address:
  • Phone: 630-527-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number036.176886
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: