Provider Demographics
NPI:1134140551
Name:SIDDIQ, MUHAMMAD Y (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:Y
Last Name:SIDDIQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 FOX VALLEY CENTER DR STE 3
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4108
Mailing Address - Country:US
Mailing Address - Phone:630-553-2545
Mailing Address - Fax:630-385-2229
Practice Address - Street 1:4075 FOX VALLEY CENTER DR STE 3
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4108
Practice Address - Country:US
Practice Address - Phone:630-553-2545
Practice Address - Fax:630-385-2229
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360982632084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036098263Medicaid
IL216017Medicare PIN
IL036098263Medicaid