Provider Demographics
NPI:1356554075
Name:SIRAJ, SANYA (MD)
Entity type:Individual
Prefix:
First Name:SANYA
Middle Name:
Last Name:SIRAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANYA
Other - Middle Name:
Other - Last Name:ASHRAF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29624 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1296
Mailing Address - Country:US
Mailing Address - Phone:608-756-6278
Mailing Address - Fax:
Practice Address - Street 1:8201 E RIVERSIDE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-2300
Practice Address - Country:US
Practice Address - Phone:815-971-4066
Practice Address - Fax:815-971-9299
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.095122208M00000X
IL036134171208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3111215Medicaid
IL036134171Medicaid
OH4310882Medicare PIN