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General NPI Number Information
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NPI Number | 1679724587
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Entity Type | Organization
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Legal Business Name | ILAHI MEDICINE OF ILLINOIS, LLC
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 6374 N LINCOLN AVE SUITE #202
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City | CHICAGO
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State | IL
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Zip | 60659-1275
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Country | US
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Telephone | 773-681-0260
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Fax | 773-304-4415
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Provider Business Mailing Address
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Address Line | 6300 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60659-1204
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Country | US
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Telephone | 773-681-0260
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Fax | 773-304-4415
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUHAIL AHMED SIDDIQUI
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Credential |
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Telephone | 773-681-0260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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