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General NPI Number Information
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NPI Number | 1528195013
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Entity Type | Organization
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Legal Business Name | FAREHA N. MALIK, M.D. LLC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 3865 N. MULFORD RD.
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City | ROCKFORD
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State | IL
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Zip | 61114-5603
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Country | US
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Telephone | 815-399-2190
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Fax | 815-399-5543
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Provider Business Mailing Address
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Address Line | 3865 N. MULFORD RD.
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City | ROCKFORD
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State | IL
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Zip | 61114-5603
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Country | US
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Telephone | 815-399-2190
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Fax | 815-399-5543
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Authorized Official
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Title or Position | OWNER
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Name | DR. FAREHA N. MALIK
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Credential | M.D.
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Telephone | 815-399-2190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State | IL
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