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Faaiza Ahmad Siddique

Radiology

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as FAAIZA SIDDIQUE.

Based on the most recent information from CMS, provider Faaiza Ahmad Siddique is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 7 days ago.

Profile Details

Provider ID
1699450692
Provider Type
Individual
Full Name
Siddique, Faaiza Ahmad
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
6/16/2023
Last Updated
5/31/2024

Contact Information

Practice Location

2160 S 1st Ave, Maywood, IL 60153-3328

(240) 538-7452

Unlisted Fax

Mailing Location

2160 S 1st Ave, Maywood, IL 60153-3328

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 240531-002009 Illinois
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Faaiza Ahmad Siddique

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Ibanez, Kent E.

Patel, Himanshu Bharat

Vade, Aruna

Freiburg, Luke M

Bova, Davide

Wrigley, Kristen Joy

Salomon, Caryl

Smith, Melissa Pawley

Ivanova, Milena

Lee, Juhyun