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General NPI Number Information
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NPI Number | 1558918409
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Entity Type | Individual
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Provider Name | CHAD M MALINOWSKI APRN, CNP
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Gender | Male
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3333 W FULLERTON AVE UNIT B
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City | CHICAGO
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State | IL
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Zip | 60647-2513
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Country | US
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Telephone | 773-257-0610
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Fax | 312-500-5037
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Provider Business Mailing Address
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Address Line | 211 GREENBRIAR DR
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City | NORMAL
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State | IL
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Zip | 61761-2287
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Country | US
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Telephone | 309-451-2080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209019919
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209019919
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License Number State | IL
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