MOMIN SAULAT SIDDIQUE (NPI# 1184852089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184852089 |
| Entity Type | Individual |
| Full Name | MOMIN SAULAT SIDDIQUE |
| Credential | M.D. |
| Practice Address |
747 N Rutledge St 5th Floor Springfield IL 62702-6700 |
| Mailing Address |
747 N Rutledge St Po Box 19627 Springfield IL 62702-6700 |
| Practice Telephone | 2175458000 |
| Practice Fax Number | 2175457063 |
| Mailing Telephone | 2175458000 |
| Mailing Fax Number | 2175457063 |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2016-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036-137934 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036137934 | 05 |
| Street Address |
747 N RUTLEDGE ST 5TH FLOOR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-6700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619974532 | Neha N Amin | Obstetrics & Gynecology | 747 N Rutledge St, Baylis Building, 2nd Floor, Springfield, IL 62702-6700 | 2005-07-07 |
| 1295343648 | Katherine G Brockhouse | Nurse Practitioner | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-07-21 |
| 1376151258 | Lauren Woldanski | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-07-16 |
| 1356968358 | Jessie Laina Koljonen | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-06-25 |
| 1487274882 | Tiffany Lynn Damm | Urology | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-04-26 |
| 1811516065 | Jazzmyne T Montgomery | Urology | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-04-08 |
| 1639738644 | Alexis Ruffolo | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2019-06-12 |
| 1922667930 | Justin D Sawyer | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2019-06-12 |
| 1174016950 | Michael Romanelli | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2018-06-07 |
| 1902398357 | William James Bruce | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2018-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366905523 | Premier Cardiac and Vascular LLC | Internal Medicine | 5514 Alma Ln Ste 200, Springfield, VA 22151-4014 | 2019-04-12 |
| 1760820930 | Shady Henien | Internal Medicine | 800 E Carpenter St # 62, Springfield, IL 62769-1000 | 2013-06-11 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1669784781 | Clifford Eugene Schott Jr. | Internal Medicine | 531 W Woodland Ave, Springfield, PA 19064-1646 | 2010-07-06 |
| 1730406760 | Joseph James Marmora | Internal Medicine | 211 Mountain Avenue, Associates In Cardiovascular Disease, Springfield, NJ 07081 | 2010-04-30 |
| 1083858310 | Brian Scott Wasserman | Internal Medicine | 3300 Main St Fl 2, Springfield, MA 01107-1112 | 2009-04-30 |
| 1104085505 | Sujata Holman | Internal Medicine | 2 Medical Center Dr Ste 410, Springfield, MA 01107-1273 | 2008-06-02 |
| 1932396157 | Centrum Cardiology, Ltd | Internal Medicine | 319 E Madison St Ste 2d, Springfield, IL 62701-3120 | 2007-10-02 |
| 1386858876 | Allen B. Weisse | Internal Medicine | 164 Hillside Ave, Springfield, NJ 07081-2808 | 2007-05-10 |
| 1467541433 | David S. Cochran | Internal Medicine | 2115 S Fremont Ave Ste 4300, Springfield, MO 65804-2232 | 2006-10-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.