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NPI Code Detail

MEDICARE: NADEEM SIDDIQUI MD

MEDICARE: NADEEM SIDDIQUI MD
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
1207RG0100XGastroenterology Physician35007WI
2207RG0100XGastroenterology Physician036175750IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770577785
Entity Type Code : Individual
Provider Name (Legal Business Name) : NADEEM SIDDIQUI MD
Provider Business Mailing Address
First Line : 1726 SHAWANO AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3216
Country : US
Telephone Number : 920-496-4700
Fax Number :
Provider Business Practice Location Address
First Line : 4309 W MEDICAL CENTER DR STE B202
Second Line :
City : MCHENRY
State : IL
Zip : 60050-8417
Country : US
Telephone Number : 847-535-6083
Fax Number : 815-455-2789
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 07/03/2025

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Directions to “ NADEEM SIDDIQUI MD” Practice Location

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