Individual
FRAAZ M SIDDIQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1345 RYAN PKWY, ALGONQUIN, IL 60102-4530
(847) 658-9555
(847) 658-2167
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-016832
IL
363LP2300X
Primary Care Nurse Practitioner
209016832
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-420139
RN LICENSE NUMBBER
IL
01
—
209-016832
ANP LICENSE NUMBER
IL
Enumeration date
11/07/2017
Last updated
05/05/2022
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