Malik Eye Institute LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

036-110588 Issued in IL

Legal business name

MALIK EYE INSTITUTE LLC

Practice address

4857 Manhattan Dr
Rockford, IL 61108-2265

Phone

(815) 399-0599

Fax

(815) 399-5543

NPI assigned

Nov 27, 2012

Last updated

Sep 6, 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

Mrs. Ranae D Bergman

Title

Manager

Phone

(815) 399-2190

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1447595780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4857 MANHATTAN DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082265",
            "telephone_number": "815-399-0599",
            "fax_number": "815-399-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4857 MANHATTAN DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082265",
            "telephone_number": "815-399-0599",
            "fax_number": "815-399-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIK EYE INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-27",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "RANAE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "815-399-2190",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "036-110588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6725940001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justyna Malanowicz
• Kimberly Malavolti, PA
• Jason H Malenfant, M.D.
• Emad Malick, PHARMD
• Malik Eye Institute LLC (Eye Specialist of Rockford)
• Malik Eye Institute LLC
• Malik Eye Institute, L.L.C.
• Masud Iqubal Malik, MD
• Victoria Malinowski
• Laurel Kristine Malloy

• 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 6, 2013; 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.