SIRAJ U SIDDIQI (NPI# 1912056318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912056318 |
| Entity Type | Individual |
| Full Name | SIRAJ U SIDDIQI |
| Credential | MD |
| Practice Address |
1019 Commerce Pkwy La Grange KY 40031-8779 |
| Mailing Address |
2700 Stanley Gault Pkwy Ste 129 Louisville KY 40223-5176 |
| Practice Telephone | 5022259098 |
| Practice Fax Number | 5022259851 |
| Mailing Telephone | 5022534900 |
| Mailing Fax Number | 5024895750 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2019-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 28062 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM | 000000052106 | 01 |
| KY | 64280621 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720170806 | Siraj U Siddiqi | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-09-28 |
| Street Address |
1019 COMMERCE PKWY |
| City | LA GRANGE |
| State | KY |
| Zip Code | 40031-8779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922194083 | Barry Brian Sosnin Jr. | Family Medicine | 1019 Commerce Pkwy, La Grange, KY 40031-8779 | 2006-10-05 |
| 1770015463 | Emilie Hood | Nurse Practitioner | 1019 Commerce Pkwy, La Grange, KY 40031-8779 | 2017-03-31 |
| 1376934950 | Dr Syed A Khader Pllc | Durable Medical Equipment & Medical Supplies | 1019 Commerce Pkwy, La Grange, KY 40031-8779 | 2015-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723089 | Nancee L Berling | Registered Nurse | 1914 Miller Ln, La Grange, KY 40031 | 2018-06-06 |
| 1134643000 | Zachary Byrne | Dentist | 3108 S. Hwy 53, Lagrange, KY 40031 | 2017-08-01 |
| 1609399971 | Walgreen Co | Pharmacy | 408 Oldham Plaza, La Grange, KY 40031 | 2017-07-19 |
| 1447790886 | Carolyn Marie Burton | Speech-Language Pathologist | 4603 Timber Walk Ct., Lagrange, KY 40031 | 2017-03-05 |
| 1699145466 | Janet Frager | Nurse Practitioner | 1023 New Moody Ln Ste 101, La Grange, KY 40031 | 2015-10-05 |
| 1730559188 | Amanda Lynn Drawbaugh | Physical Therapist | Ascb Therapy, 4603 Timber Walk Ct., Lagrange, KY 40031 | 2015-09-29 |
| 1407250483 | Aaron Mangum | Specialist/Technologist | 2850 Jericho Road, Lagrange, KY 40031 | 2014-10-20 |
| 1073944500 | Tamara Thomas | Case Manager/Care Coordinator | 4121 Spencer Ct, Lagrange, KY 40031 | 2013-12-10 |
| 1669643854 | Alisa Marie Skinner | Physical Therapist | 618 Kentucky Ave, Lagrange, KY 40031 | 2008-03-17 |
| 1245410711 | Jennifer Lee Thomas | Nurse Practitioner | 1015 New Moody Lane, Lagrange, KY 40031 | 2007-11-13 |
| Find all providers in zip 40031 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1710015664 | Kisti Marie Catalano | Internal Medicine | 23 W Calendar Ave, La Grange, IL 60525-2365 | 2007-03-01 |
| 1194874248 | Andrea Ann Krasinski | Internal Medicine | 1400 W 47 St, St 1, La Grange, IL 60525 | 2007-01-09 |
| 1194836924 | Haissam Sabbagh | Internal Medicine | Po Box 871, La Grange, IL 60525-0871 | 2006-08-31 |
| 1841229408 | Robert Passovoy | Internal Medicine | 47 6th Ave, La Grange, IL 60525-2499 | 2006-07-03 |
| 1013962562 | Nikhil Y Bhatt | Internal Medicine | 1006 New Moody Lane, La Grange, KY 40031 | 2006-05-23 |
| 1144270018 | Paige Primary Care Center | Internal Medicine | 1023 New Moody Ln, Suite 201, La Grange, KY 40031-9177 | 2006-05-11 |
| 1710989587 | William A Kcomt | Internal Medicine | 5201 S. Willow Springs Road, Suite 450, La Grange, IL 60525 | 2005-08-11 |
| 1043793441 | Wk Arthritis Care LLC | Internal Medicine | 5201 S. Willow Springs Road, Suite 450, La Grange, IL 60525 | 2018-09-11 |
| 1972998730 | Christopher Chan | Internal Medicine | 1025 New Moody Ln, La Grange, KY 40031-9154 | 2015-03-30 |
| 1457771669 | Arjun Ramesh Ghodasara | Internal Medicine | 1025 New Moody Ln, La Grange, KY 40031-9154 | 2014-04-27 |
| Find all providers in LA GRANGE | ||||
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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.