Organization
MALHOTRA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHASHI K MALHOTRA M.D. (OWNER)
(708) 633-9000
Entity
Organization
Contact information
Practice address
16750 80TH AVE, SUITE E, TINLEY PARK, IL 60477-3173
(708) 633-9000
(708) 633-9016
Mailing address
PO BOX 970, MATTESON, IL 60443-0970
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-052517
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633163
BCBSIL GROUP #
IL
Enumeration date
05/23/2006
Last updated
08/18/2008
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