Individual
ADNAN SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12774 BOENKER LN, BRIDGETON, MO 63044-2436
(314) 291-7997
(314) 739-1471
Mailing address
PO BOX 776874, CHICAGO, IL 60677-6874
(314) 291-7997
(314) 739-1471
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2005009473
MO
207RI0200X
Infectious Disease Physician
036136783
IL
207RI0200X
Infectious Disease Physician
Primary
2005009473
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207582008
—
MO
Enumeration date
02/21/2006
Last updated
08/06/2023
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