Malik Eye Institute LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

036-110588 Issued in IL

Legal business name

MALIK EYE INSTITUTE LLC

Doing business as

Eye Specialist of Rockford

Practice address

3865 N Mulford Rd
Rockford, IL 61114-5603

Phone

(815) 399-2190

Fax

(815) 399-5543

NPI assigned

Sep 13, 2013

Last updated

Sep 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Masud I Malik, M.D.NPI 1679580807

Title

Physician and Owner

Phone

(815) 399-2190

Specialties & licenses 1

Addresses

Other names 1

• Eye Specialist of Rockford Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Malik Eye Institute, L.L.C.

  • Ophthalmology Physician
  • Rockford, IL
  • NPI 1902906803

  2668470980

  Same PAC ID

Tax ID family

Malik Eye Institute LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Malik Eye Institute LLC

  • Ophthalmology Physician
  • Rockford, IL
  • NPI 1538404827
  NPD tax ID
• Malik Eye Institute, L.L.C.

  • Ophthalmology Physician
  • Rockford, IL
  • NPI 1902906803
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Masud Iqubal Malik, MD

  • Ophthalmology Physician
  • Rockford, IL
  • NPI 1679580807
  NPD Authorized official
• Anita Palmer-Hall, O.D.

  • Optometrist
  • Rockford, IL
  • NPI 1598824203
  NPD
• Mohammed O Peracha, MD

  • Ophthalmology Physician
  • Calumet City, IL
  • NPI 1982606950
  NPD
• Ajay K Gupta, M.D.

  • Ophthalmology Physician
  • Sheboygan, WI
  • NPI 1316049265
  NPD

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1407281009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145603",
            "telephone_number": "815-399-2190",
            "fax_number": "815-399-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145603",
            "telephone_number": "815-399-2190",
            "fax_number": "815-399-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIK EYE INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "MASUD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PHYSICIAN AND OWNER",
        "authorized_official_telephone_number": "815-399-2190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "036-110588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Specialist of Rockford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raquel Malabanan, MD
• Justyna Malanowicz
• Kimberly Malavolti, PA
• Jason H Malenfant, M.D.
• Emad Malick, PHARMD
• Malik Eye Institute LLC
• Malik Eye Institute LLC
• Malik Eye Institute, L.L.C.
• Masud Iqubal Malik, MD
• Victoria Malinowski

• Eyewear Supplier in Rockford, IL
• Providers in Rockford, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.