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Individual

MR. MICHAEL MALONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5159 S. ASHLAND AVE, CHICAGO, IL 60609-5322
(773) 434-9216
(773) 434-2670
Mailing address
5050 S STATE ST, CHICAGO, IL 60609-5302
(773) 924-5898
(773) 924-5791

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-103685
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036103685
IL
Enumeration date
10/31/2006
Last updated
02/11/2014
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