Individual
ATA U. SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
(618) 541-5810
Mailing address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5810
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036-094419
IL
207L00000X
Anesthesiology Physician
107869
MO
207L00000X
Anesthesiology Physician
N4099
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203941224
—
MO
Enumeration date
09/20/2005
Last updated
11/16/2021
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