Provider Demographics
NPI:1093535486
Name:SIDDIG, NIDHAL (MD)
Entity type:Individual
Prefix:
First Name:NIDHAL
Middle Name:
Last Name:SIDDIG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5240 N WINTHROP AVE APT 109
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-0516
Mailing Address - Country:US
Mailing Address - Phone:810-625-8987
Mailing Address - Fax:
Practice Address - Street 1:5240 N WINTHROP AVE APT 109
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-0516
Practice Address - Country:US
Practice Address - Phone:810-625-8987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125.0850602084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology