Provider Demographics
NPI:1790948180
Name:SIDANI, AMER A (MD)
Entity Type:Individual
Prefix:
First Name:AMER
Middle Name:A
Last Name:SIDANI
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 1:1001 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1596
Mailing Address - Country:US
Mailing Address - Phone:219-924-8178
Mailing Address - Fax:219-924-8179
Practice Address - Street 1:1600 S LAKE PARK AVE STE 1101
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6641
Practice Address - Country:US
Practice Address - Phone:219-947-1795
Practice Address - Fax:219-947-9834
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN01075501A207RH0003X
IL036.126104207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine