Malik Martiz Barnes
Individual provider Active NPI Adult Care Home Facility · Crete, IL
NPI 1609656313 · NPPES record last updated Oct 2, 2023
Key facts
- NPI
- 1609656313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Care Home Facility 311ZA0620X
- Practice address
- 3494 Fairway Dr # 0
Crete, IL 60417-1000 - Phone
- (708) 466-7322
- NPI assigned
- Oct 2, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wavebridge Enterprise Inc | Adult Care Home | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | Yes |
Addresses
Primary practice location
3494 Fairway Dr # 0
Crete, IL 60417-1000
Mailing address
3494 Fairway Dr # 0
Crete, IL 60417-1000
Phone (708) 466-7322
Other names
- Cameron Barnes
Other providers in Crete, IL
- American Warriors Inc
- Amor Blessings
- Jack Christopher Amram
- James Douglas Amram
- Archos Multispecialty Services, Inc
- Rachel Oriel Berg
- Besst Enterprises Co
- Ray Besst
- Rita Bianchi
- Joanne Marie Bradley
All providers in Crete, IL · Adult Care Home Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.