Provider Demographics
NPI:1972776516
Name:SIDDIQUI, BAZGHA (MD)
Entity Type:Individual
Prefix:DR
First Name:BAZGHA
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BAZGHA
Other - Middle Name:
Other - Last Name:REHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1051 ESSINGTON ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2812
Mailing Address - Country:US
Mailing Address - Phone:815-726-1818
Mailing Address - Fax:815-726-0232
Practice Address - Street 1:1051 ESSINGTON ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2812
Practice Address - Country:US
Practice Address - Phone:815-726-1818
Practice Address - Fax:815-726-0232
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036127654207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease