Individual
JOSEPH MALCOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4147 CALLERY RD, NAPERVILLE, IL 60564-5006
(630) 276-9363
Mailing address
4147 CALLERY RD, NAPERVILLE, IL 60564-5006
(630) 276-9363
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209-024202
IL
Other
Enumeration date
10/31/2021
Last updated
10/31/2021
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