Provider Demographics
NPI:1316986920
Name:SAADUDDIN, SYED (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:SAADUDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 115TH ST
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-8753
Mailing Address - Country:US
Mailing Address - Phone:630-789-6455
Mailing Address - Fax:773-955-5580
Practice Address - Street 1:401 E 61ST ST
Practice Address - Street 2:S&F MEDICAL CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-2324
Practice Address - Country:US
Practice Address - Phone:773-955-5560
Practice Address - Fax:773-955-5580
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-081114208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0031604575OtherBLUE CROSS BLUE SHIELD IL
IL036081114Medicaid
ILF36736Medicare UPIN
IL985650Medicare ID - Type Unspecified