| Tj Siddiqui Inc | |
|
11113 Woodstock Dr Orland Park IL 60467-7611 | |
| (708) 351-0292 | |
| Not Available |
| Full Name | Tj Siddiqui Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11113 Woodstock Dr, Orland Park, Illinois |
| Authorized Official Name and Position | Tahseen J Siddiqui (OWNER) |
| Authorized Official Contact | 7083510292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tj Siddiqui Inc 11113 Woodstock Dr Orland Park IL 60467-7611 Ph: () - | Tj Siddiqui Inc 11113 Woodstock Dr Orland Park IL 60467-7611 Ph: (708) 351-0292 |
| NPI Number | 1053546820 |
|---|---|
| Provider Enumeration Date | 05/22/2009 |
| Last Update Date | 05/27/2009 |
| Medicare PECOS PAC ID | 9931250339 |
|---|---|
| Medicare Enrollment ID | O20090624000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053546820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 036.105217 (Illinois) | Primary |
| Provider Name | Tahseen J Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487715264 PECOS PAC ID: 8123127586 Enrollment ID: I20070626000280 |
| Provider Name | Teia L Atwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205165222 PECOS PAC ID: 0648305193 Enrollment ID: I20100323000194 |
| Provider Name | Mateo Betanzos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457767998 PECOS PAC ID: 4486871050 Enrollment ID: I20140806000984 |
| Provider Name | Cynthia L Hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992171326 PECOS PAC ID: 9830405745 Enrollment ID: I20150908001789 |
| Provider Name | Patricia Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730622952 PECOS PAC ID: 5294017166 Enrollment ID: I20170130001119 |
| Provider Name | Jolanta E Saluja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356855878 PECOS PAC ID: 7113286121 Enrollment ID: I20180122000433 |
| Provider Name | Adriane T Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407339765 PECOS PAC ID: 5496007015 Enrollment ID: I20181010000604 |
| Provider Name | Zimuzo Crystal Onwuekwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356817175 PECOS PAC ID: 3476894452 Enrollment ID: I20190402000723 |
| Provider Name | Patricia Ludwikowska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699319723 PECOS PAC ID: 9335574334 Enrollment ID: I20200122001146 |
| Provider Name | Carol Halasan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881149078 PECOS PAC ID: 0446547764 Enrollment ID: I20210623002397 |
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