MASOOD SIDDIQUI MBA, NPI 1578745576 — CHICAGO (IL)

NPI 1578745576

12+ Years Experience Individual

MASOOD SIDDIQUI MBA

11/30/2007
PROVIDER ENUMERATION DATE
09/17/2016
LAST UPDATE DATE
1578745576
NPI NUMBER

About MASOOD SIDDIQUI

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

MASOOD SIDDIQUI is a provider established in CHICAGO, IL. The NPI number of MASOOD SIDDIQUI is 1578745576 and was assigned on 11/30/2007. The practitioners primary taxonomy code is: 2471C3402X .

Mailing address

  • City: CHICAGO
  • State: IL
  • Postal code: 606451735
  • Phone: 7732624432
  • Fax: 7732624712
  • Address: 7455 N WESTERN AVE

Primary Practice Address

  • Region : CHICAGO, IL
  • NPI : 1578745576
  • Phone : 7732624432
  • Fax : 7732624712
  • Postalcode : 606451735
  • Address : 7455 N WESTERN AVE

Provider taxonomy - Radiologic Technologist

  • Taxonomy code: 2471C3402X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Healthcare provider taxonomy #2 - Radiologic Technologist

  • Taxonomy code: 2471S1302X

The taxonomy is not the primary taxonomy.

Contacts:

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  • MASOOD SIDDIQUI MBA
  • Address : 7455 N WESTERN AVE
  • Region : CHICAGO, IL
  • NPI : 1578745576
  • Phone : 7732624432
  • Fax : 7732624712
  • Postalcode : 606451735

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address7455 N WESTERN AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCHICAGO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameIL
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code606451735
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number7732624432
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number7732624712
The fax number associated with the location address of the provider being identified.
NPI1578745576
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 12471C3402X
Provider Enumeration Date11/30/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated09/17/2016
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MASOOD SIDDIQUI
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address7455 N WESTERN AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameCHICAGO
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameIL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code606451735
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7732624432
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number7732624712
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #12471C3402X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Radiologic Technologist
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 22471S1302X
Healthcare Provider Taxonomy 2Radiologic Technologist
Healthcare Provider Primary Taxonomy Switch 2N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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