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NPI Code Detail

MEDICARE: PRATIBHA KATYAL MALHOTRA

MEDICARE: PRATIBHA KATYAL MALHOTRA
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
1208000000XPediatrics Physician03645620IL

General Provider Information

NPI Number : 1629089818
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRATIBHA KATYAL MALHOTRA
Provider Business Mailing Address
First Line : 1401 W DUGDALE RD
Second Line :
City : WAUKEGAN
State : IL
Zip : 60085-6263
Country : US
Telephone Number : 847-249-0600
Fax Number :
Provider Business Practice Location Address
First Line : 1401 W DUGDALE RD
Second Line :
City : WAUKEGAN
State : IL
Zip : 60085-6263
Country : US
Telephone Number : 847-249-0600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 04/30/2010

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Directions to “ PRATIBHA KATYAL MALHOTRA ” Practice Location

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