Provider Demographics
NPI:1184670671
Name:SIDDIQUI, ARSHEA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARSHEA
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 SUTTON LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9458
Mailing Address - Country:US
Mailing Address - Phone:630-981-7250
Mailing Address - Fax:630-396-9786
Practice Address - Street 1:2516 SUTTON LN
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9458
Practice Address - Country:US
Practice Address - Phone:630-981-7250
Practice Address - Fax:630-396-9786
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036107661207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208341OtherGROUP MEDICARE PTAN
IL208342OtherGROUP MEDICARE PTAN