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Contact Information

ESRA SIDDEEK, DO
1821 S WEBSTER AVE
GREEN BAY, WI54301-2253
 Phone: 920-496-4700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuromusculoskeletal Medicine & OMM

204D00000X 12 Physician/Osteopathic Manipulative Medicine
Indicates primary specialty

NPI Profile & details for ESRA SIDDEEK · (Female)

NPI Number 1073184933
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/01/2021
Last updated 08/01/2025 - About 10 months ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2021021665
  • WI License # 81874-21
  • WI Medicaid 100326593
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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