Individual provider Active NPI

Nour Malak, D.N.

  • Specialist
  • Homewood, IL
National Provider Identifier
1104942309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
18019 Dixie Hwy Ste 1C
Homewood, IL 60430-3059
Phone
(708) 798-8595
Fax
(708) 798-8476
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

18019 Dixie Hwy Ste 1C
Homewood, IL 60430-3059

Mailing address

1518 Olive Rd
Homewood, IL 60430-2312
Phone (708) 798-8595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
181-000225ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Homewood Naprapathic Pain Management Center, P.C. Specialist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104942309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 OLIVE RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302312",
            "telephone_number": "708-798-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18019 DIXIE HWY STE 1C",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303059",
            "telephone_number": "708-798-8595",
            "fax_number": "708-798-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAK",
        "first_name": "NOUR",
        "name_prefix": "Dr.",
        "credential": "D.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.