Individual provider Active NPI

Madhurita Malhotra, MD

  • Psychiatry Physician
  • Naperville, IL
National Provider Identifier
1245328699
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036100407 Issued in IL
Practice address
4305 Lone Tree CT
Naperville, IL 60564-9794
Phone
(630) 800-1350
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD070894L PA
Psychiatry Physician 2084P0800X 036100407 IL Primary

Addresses

Primary practice location

4305 Lone Tree CT
Naperville, IL 60564-9794

Mailing address

4305 Lone Tree CT
Naperville, IL 60564-9794
Phone (630) 800-1350

Other identifiers 2

IdentifierTypeStateIssuer
036100407MedicaidIL
100889522001MedicaidPA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD070894LPAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1245328699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 LONE TREE CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649794",
            "telephone_number": "630-800-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 LONE TREE CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649794",
            "telephone_number": "630-800-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "MADHURITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD070894L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036100407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100407",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100889522001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.