Individual
DR. DENNIS EUGENE MALECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 W 95TH ST, SUITE 6, HICKORY HILLS, IL 60457-2700
(708) 430-2400
(708) 430-2417
Mailing address
8700 W 95TH ST, SUITE 6, HICKORY HILLS, IL 60457-2700
(708) 430-2400
(708) 430-2417
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
03652516
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036052516
—
IL
01
—
080037003
PALMETTO GBA RAIL ROAD MEDICARE
IL
01
—
363137473
TAX ID
IL
Enumeration date
08/22/2005
Last updated
05/05/2008
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