Individual
DR. MASUD IQUBAL MALIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3865 NORTH MULFORD ROAD, ROCKFORD, IL 61114
(815) 399-2190
(815) 399-5543
Mailing address
3865 N MULFORD ROAD, ROCKFORD, IL 61114
(815) 399-2190
(815) 399-5543
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-110588
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110588
—
IL
01
—
214298
MEDICARE ID UNSPECIFIED
IL
Enumeration date
08/01/2006
Last updated
07/23/2014
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