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NPI Code Detail

MEDICARE: SARRAH MALKE RDH

MEDICARE: SARRAH MALKE RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist020014709IL

General Provider Information

NPI Number : 1164807434
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARRAH MALKE RDH
Provider Business Mailing Address
First Line : 3143 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-1424
Country : US
Telephone Number : 773-465-2922
Fax Number :
Provider Business Practice Location Address
First Line : 3143 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-1424
Country : US
Telephone Number : 773-465-2922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2015
Last Update Date : 07/28/2015

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Directions to “ SARRAH MALKE RDH” Practice Location

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