Robert G Malloy, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Practice address

1170 E Belvidere Rd
#106 Mundelein Pediatrics SC
Grayslake, IL 60030-2061

Phone

(847) 548-7337

Fax

(847) 548-9909

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mundelein Pediatrics, S.C.

  • Pediatric Adolescent Medicine Physician
  • Grayslake, IL
  • NPI 1336294800
  NPD (past) Authorized official

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922092048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "SUITE 106",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302061",
            "telephone_number": "847-548-7337",
            "fax_number": "847-548-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "#106 MUNDELEIN PEDIATRICS SC",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302061",
            "telephone_number": "847-548-7337",
            "fax_number": "847-548-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hetty M. Macdowell, LMT
• Ariel Magallon, MD
• Nicholas Emile Maldonado
• Krithika Malhotra, PHD
• Jordan Mallery
• Manjote K Dhaliwal DDS PC
• Anna Maria Mankowska, M.A.
• Christopher Manning, L.AC.
• Tina Yun Mantanona, MD
• Chloe Christy Manzella, PA-C

• Pediatric Adolescent Medicine Physician in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Pediatric Adolescent Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.