Siddiqui, Mumtaz A

Siddiqui, Mumtaz A is an individual health care provider with primary practice located at 1302 Franklin Ave Suite 4500, Normal IL 61761-3551. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Siddiqui, Mumtaz A can be contacted via phone (309) 828-1166.

Contact Information

Primary practice address
1302 Franklin Ave Suite 4500 Normal IL 61761-3551
Phone: (309) 828-1166
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X Illinois

Profile Details

NPI number 1679569925
LBN Legal business name Siddiqui, Mumtaz A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Feb 27th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679569925 NPPES
Illinois Other 212636 MEDICARE GROUP NUMBER
Illinois Other 05732097 MEDICARE GROUP NUMBER

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