Nadir Mallick, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301099249 Issued in MI

Practice address

20180 S Lagrange Rd
Frankfort, IL 60423-3153

Phone

(815) 464-2010

Fax

(815) 464-2181

NPI assigned

Jun 28, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan College of Medicine and Surgery, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crystal Lake Immediate Care Physicians LTD.Group PAC ID 2961783139, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmallick236371@direct.myadvocateaurora.org

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.

• Crystal Lake Immediate Care Physicians LTD.

  • Emergency Medicine Physician
  • Crystal Lake, IL
  • NPI 1538517198
  Medicare reassignment Care Compare group NPD
• Tri-County Emergency Physicians, LTD

  • Emergency Medicine Physician
  • Barrington, IL
  • NPI 1700810470
  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Barrington, IL
  • NPI 1447368071
  Care Compare affiliation

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1386930428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "SUITE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437241",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20180 S LAGRANGE RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233153",
            "telephone_number": "815-464-2010",
            "fax_number": "815-464-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "NADIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301099249",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301099249",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400183639",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036136607",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josephine F Lytton
• Ryan Thomas Maccracken
• Colleen Elizabeth Maguire, OTR/L
• Gabrielle Malec
• Manjeev Malhotra, DDS
• Justin Manaparambil, PHARMD
• Errin Lynn Manney, MD
• Mansell Consulting LLC
• Lauren Mansell, PT
• Candice Marden

• Family Medicine Physician in Frankfort, IL
• Providers in Frankfort, 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 Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.