Individual
DR. MUMTAZ AHMED SIDDIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
552 N MCLEAN BLVD, ELGIN, IL 60123
(847) 931-9744
(847) 931-7726
Mailing address
552 N MCLEAN BLVD, ELGIN, IL 60123
(847) 931-9744
(847) 931-7726
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-022632
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003729
—
IL
Enumeration date
09/01/2006
Last updated
07/08/2007
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