Organization
UROLOGICAL SURGEONS ASSOCIATED CHARTERED
Active
Other names
Thomas C Malvar MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS C MALVAR M.D. (PRESIDENT)
(773) 248-2842
Entity
Organization
Contact information
Practice address
2800 N SHERIDAN RD, SUITE 602, CHICAGO, IL 60657-6156
(773) 248-2842
Mailing address
PO BOX 798, PARK RIDGE, IL 60068-0798
(847) 692-6218
(847) 692-6560
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046237
—
IL
01
—
21604584
BC BS
—
01
—
CM4130
PALMETTO GBA
—
Enumeration date
01/11/2007
Last updated
10/22/2008
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