Individual
MALCOLM A DEAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 ERIE CT, SUITE L500, OAK PARK, IL 60302-2566
(708) 763-6478
(708) 383-1793
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036043300
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036043300
—
IL
01
—
110044982
RAILROAD MEDICARE
IL
01
—
2160743632
BCBS PROVIDER ID
IL
01
—
363150672
OWCP PROVIDER ID
IL
Enumeration date
09/15/2005
Last updated
12/17/2010
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