Provider Demographics
NPI:1497953756
Name:SIDDIQUI, SALEEM WONG (DDS)
Entity type:Individual
Prefix:DR
First Name:SALEEM
Middle Name:WONG
Last Name:SIDDIQUI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W WELLINGTON AVE APT 9W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6926
Mailing Address - Country:US
Mailing Address - Phone:312-882-2239
Mailing Address - Fax:
Practice Address - Street 1:2879 95TH ST STE 131
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9008
Practice Address - Country:US
Practice Address - Phone:630-753-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027579122300000X
IL021.0025361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist