Provider Demographics
NPI:1801468111
Name:SIDDIQUI, SAADIA B (MA)
Entity type:Individual
Prefix:
First Name:SAADIA
Middle Name:B
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SAADIA
Other - Middle Name:B
Other - Last Name:FAROOQI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 E LAKE DR APT 725
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-4608
Mailing Address - Country:US
Mailing Address - Phone:306-538-9410
Mailing Address - Fax:
Practice Address - Street 1:1845 GRANDSTAND PL
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-6603
Practice Address - Country:US
Practice Address - Phone:847-695-0484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL351235528Medicaid