Individual provider Active NPI

Wendell R Malalis, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Sycamore, IL
National Provider Identifier
1962692418
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036-130456 Issued in IL
Practice address
1850 Gateway Dr
Sycamore, IL 60178
Phone
(815) 754-1097
Fax
(815) 748-8957
NPI assigned
Jul 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036-130456 IL Primary

Addresses

Primary practice location

1850 Gateway Dr
Sycamore, IL 60178

Mailing address

1850 Gateway Dr
Sycamore, IL 60178-3192
Phone (815) 754-1097

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121003000768 IL Practitioner - Endocrinology 6800045014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1850 Gateway Dr
Sycamore, IL 60178-3192
Phone (630) 232-0280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-130456ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Endocrinology, Diabetes & Metabolism CurrentSince Sep 1, 2018 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2018 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

224 E Railroad St
Sandwich, IL 60548
Phone (815) 786-7150

1850 Gateway Dr
Sycamore, IL 60178
Phone (815) 217-3252

1850 Gateway Dr
Ste 205
Sycamore, IL 60178
Phone (815) 754-1097

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1962692418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-754-1097",
            "fax_number": "815-748-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-754-1097",
            "fax_number": "815-748-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALALIS",
        "first_name": "WENDELL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036-130456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.