| Dr Gulam M T Siddiqui, M D | |
|
800 School St, Carrollton, IL 62016-1436 | |
| (217) 942-6946 | |
| (217) 942-9349 |
| Full Name | Dr Gulam M T Siddiqui |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Experience | 42 Years |
| Location | 800 School St, Carrollton, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720131188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036-072949 (Illinois) | Primary |
| 208D00000X | General Practice | 036072949 (Illinois) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Thomas H Boyd Memorial Hospital | Carrollton, IL | Hospital |
| Carlinville Area Hospital | Carlinville, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sanburg Emergency Group, P.c. | 4688003957 | 16 |
| Thomas H Boyd Memorial Hospital | 8123085560 | 22 |
| Entity Name | Carlinville Area Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932275641 PECOS PAC ID: 9032021373 Enrollment ID: O20031104000520 |
| Entity Name | Thomas H Boyd Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811096811 PECOS PAC ID: 8123085560 Enrollment ID: O20041216000800 |
| Entity Name | Thomas H Boyd Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1811096811 PECOS PAC ID: 8123085560 Enrollment ID: O20110118000703 |
| Entity Name | Thomas H Boyd Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1699973685 PECOS PAC ID: 8123085560 Enrollment ID: O20110118000988 |
| Entity Name | Sanburg Emergency Group, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992337000 PECOS PAC ID: 4688003957 Enrollment ID: O20200408000461 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gulam M T Siddiqui, M D 942 Aspen Dr, Lombard, IL 60148-4254 Ph: (630) 935-8431 | Dr Gulam M T Siddiqui, M D 800 School St, Carrollton, IL 62016-1436 Ph: (217) 942-6946 |
Dr. Mohammed W Siddiqui, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 School St, Carrollton, IL 62016 Phone: 217-942-6946 Fax: 217-942-9349 |