MEDICARE: MALGORZATA KRYSTYNA BACH MD

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
1	2084N0400X	Neurology Physician	036115194	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801852322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALGORZATA KRYSTYNA BACH MD

Provider Business Mailing Address
First Line	:	355 GREENLEAF ST STE H
Second Line	:
City	:	PARK CITY
State	:	IL
Zip	:	60085-5708
Country	:	US
Telephone Number	:	847-230-7523
Fax Number	:	847-999-3859

Provider Business Practice Location Address
First Line	:	355 GREENLEAF ST STE H
Second Line	:
City	:	PARK CITY
State	:	IL
Zip	:	60085-5708
Country	:	US
Telephone Number	:	847-230-7523
Fax Number	:	847-999-3859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	02/13/2026

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