Healthcare Provider Details

I. General information

NPI: 1679860605
Provider Name (Legal Business Name): RUBINDER KAUR MALCZEWSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 OGDEN AVE SUITE 325
AURORA IL
60504-5894
US

IV. Provider business mailing address

1017 W GLEN OAKS LN STE 203
MEQUON WI
53092-3376
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-4850
  • Fax: 630-978-6865
Mailing address:
  • Phone: 262-420-4008
  • Fax: 262-236-9190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125.060545
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: