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General NPI Number Information
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NPI Number | 1891707923
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Entity Type | Individual
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Provider Name | ALI M MALICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | GALENA
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State | IL
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Zip | 61036-8118
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Country | US
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Telephone | 815-777-1340
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Fax | 815-776-7385
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Provider Business Mailing Address
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Address Line | 360 STATION DR
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-7978
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Country | US
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Telephone | 815-338-6600
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Fax | 815-356-2351
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 036129438
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 036-129438
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License Number State | IL
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