{"npi":"1295239804","type":"NPI-1","status":"active","name":{"display":"Dr. Nathan Siesener MD","other":[],"first":"NATHAN","last":"SIESENER","middle":"JOSEPH","credential":"MD"},"specialty":{"primary_taxonomy":"2085R0202X","primary_taxonomy_description":"Diagnostic Radiology","slug":"diagnostic-radiology","schema_org_specialty":"Radiography","all":[{"code":"2085R0202X","description":"Diagnostic Radiology","primary":true,"state":"IL","license":"036164864"}]},"addresses":[{"purpose":"LOCATION","street_1":"4500 MEMORIAL DR","city":"BELLEVILLE","state":"IL","postal_code":"622265360","country_code":"US","street_2":"DEPT RADIOLOGY","phone":"6182575613","fax":"3144544641"},{"purpose":"MAILING","street_1":"PO BOX 7412011","city":"CHICAGO","state":"IL","postal_code":"606742011","country_code":"US","phone":"6182575613","fax":"3144544641"}],"license":{"state":"IL","number":"036164864"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"200128296","state":"MO","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20230728003077","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"IL","pac_id":"7719216423"},{"enrlmt_id":"I20230731000155","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"GA","pac_id":"7719216423"},{"enrlmt_id":"I20230804000389","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"IN","pac_id":"7719216423"},{"enrlmt_id":"I20230804003576","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"MO","pac_id":"7719216423"}]},"enumeration_date":"2018-03-19","last_updated":"2025-10-21","_meta":{"source":"NPPES","snapshot_date":"2025-10-21","doc_url":"https://findmynpi.com/api"}}