Clayton R. Malaker, M.D., S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-075458 Issued in IL

Legal business name

CLAYTON R. MALAKER, M.D., S.C.

Practice address

824 Van Buren St
Belvidere, IL 61008-2252

Phone

(815) 544-3481

NPI assigned

Dec 16, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Clayton R. Malaker, M.D.NPI 1144221961

Title

President

Phone

(815) 544-3481

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clayton R. Malaker, M.D.

  • Family Medicine Physician
  • Belvidere, IL
  • NPI 1144221961
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1144559485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 VAN BUREN ST",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610082252",
            "telephone_number": "815-544-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 VAN BUREN ST",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610082252",
            "telephone_number": "815-544-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON R. MALAKER, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "MALAKER",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-544-3481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-075458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "036-075458",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "0000400014",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075458",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shin Chen, MD
• Kayen Eudora Cheung
• Brian Choe
• CHW
• City of Belvidere
• Ronald Frederick Conder Sr., DDS
• Confident Smile Dental PC
• Michael Gregory Congoran Jr., CCC-SLP/L
• Nicole Connell
• Michael David Corcoran, D.P.M.

• Family Medicine Physician in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.