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Individual

DR. NAVEED K MALLICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1642 E 56TH ST, SUITE 107, CHICAGO, IL 60637-1952
(773) 321-0200
(877) 863-7393
Mailing address
1642 E 56TH ST, SUITE 107, CHICAGO, IL 60637-1952
(773) 321-0200
(877) 863-7393

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-101915
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
036101915
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036101915
IL
01
13336472851
BCBS GROUP NUMBER
IL
01
1336472851
NPI GROUP NUMBER
IL
01
1600527
BCBS INDIVIDUAL NUMBER
IL
01
3203001
PTAN INDIVIDUAL
IL
01
DS3487
RAILROAD MEDICARE PTAN
IL
01
IL3203
PTAN GROUP
IL
Enumeration date
12/28/2006
Last updated
03/13/2025
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