Provider Demographics
NPI:1376612630
Name:MUHAMMAD Y SIDDIQ SC
Entity Type:Organization
Organization Name:MUHAMMAD Y SIDDIQ SC
Other - Org Name:SUBURBAN PHYSICIANS SC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SIDDIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-553-2545
Mailing Address - Street 1:4075 FOX VALLEY CENTER DR, UNIT 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:630-978-1111
Mailing Address - Fax:630-978-1180
Practice Address - Street 1:4075 FOX VALLEY CENTER DR, UNIT 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:630-978-1111
Practice Address - Fax:630-978-1180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036098263Medicaid
ILH13078Medicare UPIN