MEDICARE: SYED SAADUDDIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	036-081114	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0031604575	OTHER	IL	BLUE CROSS BLUE SHIELD IL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316986920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED SAADUDDIN M.D.

Provider Business Mailing Address
First Line	:	3 115TH ST
Second Line	:
City	:	LEMONT
State	:	IL
Zip	:	60439-8753
Country	:	US
Telephone Number	:	630-789-6455
Fax Number	:	773-955-5580

Provider Business Practice Location Address
First Line	:	401 E 61ST ST
Second Line	:	S&F MEDICAL CENTER
City	:	CHICAGO
State	:	IL
Zip	:	60637-2324
Country	:	US
Telephone Number	:	773-955-5560
Fax Number	:	773-955-5580

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	01/21/2015

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