Healthcare Provider Details

I. General information

NPI: 1558704700
Provider Name (Legal Business Name): RISHI ZAVERI MALHOTRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S YORK ST STE 4180
ELMHURST IL
60126-5630
US

IV. Provider business mailing address

4201 WINFIELD RD FL 3
WARRENVILLE IL
60555-4025
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-9004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number036150382
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number036150382
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: