Provider Demographics
NPI:1871547638
Name:MALIK, FARAH (MD)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:207 HILLCREST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1393
Mailing Address - Country:US
Mailing Address - Phone:630-553-2111
Mailing Address - Fax:630-553-0022
Practice Address - Street 1:207 HILLCREST AVE STE A
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1393
Practice Address - Country:US
Practice Address - Phone:630-553-2111
Practice Address - Fax:630-553-0022
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-110764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I16733Medicare UPIN