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Individual

DR. ANTO VARGHESE MALIAKKAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D. H.M.D.C

Contact information

Practice address
8S165 S VINE ST, BURR RIDGE, IL 60527-5541
(630) 835-7613
Mailing address
8S165 S VINE ST, BURR RIDGE, IL 60527-5541
(630) 835-7613

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01042537A
IN
207R00000X
Internal Medicine Physician
Primary
0366083220
IL
207R00000X
Internal Medicine Physician
C54950
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
01042537A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
0366083220
IL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
C54950
CA

Other

Enumeration date
07/30/2006
Last updated
05/31/2023
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