Healthcare Provider Details

I. General information

NPI: 1790724169
Provider Name (Legal Business Name): DR. W. S. MALHAS, S. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 W 68TH ST
CHICAGO IL
60629-1813
US

IV. Provider business mailing address

1730 PARK ST SUITE 101
NAPERVILLE IL
60563-2688
US

V. Phone/Fax

Practice location:
  • Phone: 312-471-8000
  • Fax:
Mailing address:
  • Phone: 630-718-0200
  • Fax: 630-718-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WADE MALHAS
Title or Position: PHYSICIAN / OWNER
Credential: M.D.
Phone: 630-718-0200