Individual
KYLE M MALECKI
Active
Individual
KYLE M MALECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.071862
IL
2085R0202X
Diagnostic Radiology Physician
Primary
01089671A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300026706
—
IN
01
—
959090186
MEDICARE PTAN
IN
Enumeration date
03/20/2018
Last updated
08/17/2023
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