Organization
KIDNEY AND HYPERTENSION CARE MID-AMERICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHER S MALLICK MD (OWNER)
(314) 628-7750
Entity
Organization
Contact information
Practice address
400 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2028
(314) 628-7750
Mailing address
PO BOX 289, CHESTERFIELD, MO 63006-0289
(314) 628-7750
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03609903
—
IL
Enumeration date
02/21/2024
Last updated
10/21/2025
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