Individual
DR. AJAY R MALPANI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 FORT JESSE RD, SUITE 280, NORMAL, IL 61761-6286
(309) 452-1788
(309) 862-1302
Mailing address
2200 FORT JESSE RD, SUITE 280, NORMAL, IL 61761-6286
(309) 452-1788
(309) 862-1302
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
36081598
IL
2085R0202X
Diagnostic Radiology Physician
36081598
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081598*1
—
IL
Enumeration date
05/23/2006
Last updated
09/11/2025
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