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NPI Code Detail

MEDICARE: DR. SANJEEV MALIK M.D.

MEDICARE: DR. SANJEEV MALIK M.D.
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
1207PS0010XSports Medicine (Emergency Medicine) Physician036116869IL
2207P00000XEmergency Medicine Physician36116869IL

General Provider Information

NPI Number : 1205950508
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANJEEV MALIK M.D.
Provider Business Mailing Address
First Line : 211 E ONTARIO ST STE 200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3284
Country : US
Telephone Number : 312-694-7000
Fax Number :
Provider Business Practice Location Address
First Line : 251 E HURON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2908
Country : US
Telephone Number : 312-694-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/21/2022

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