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General NPI Number Information
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NPI Number | 1104046630
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Entity Type | Individual
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Provider Name | SYED WALIUDDIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 75 MARKET ST SUITE 14
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City | ELGIN
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State | IL
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Zip | 60123-5093
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Country | US
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Telephone | 847-697-6290
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Fax | 847-697-0252
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Provider Business Mailing Address
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Address Line | 75 MARKET ST SUITE 14
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City | ELGIN
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State | IL
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Zip | 60123-5093
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Country | US
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Telephone | 847-697-6290
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Fax | 847-697-0252
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 50282
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 50282
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036119726
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01097770A
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License Number State | IN
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