Individual provider Active NPI

Malik Abraham, DPM

  • Podiatrist
  • Arlington Heights, IL
National Provider Identifier
1972584464
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016003708 Issued in IL
Practice address
3030 W Salt Creek LN
Suite 100
Arlington Heights, IL 60005-5001
Phone
(847) 870-4200
Fax
(847) 870-0059
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016003708 IL Primary
Podiatrist 213E00000X PO 3467 FL

Addresses

Primary practice location

3030 W Salt Creek LN
Suite 100
Arlington Heights, IL 60005-5001

Mailing address

3030 W Salt Creek LN
Suite 100
Arlington Heights, IL 60005-5001
Phone (847) 870-4200

Other identifiers 2

IdentifierTypeStateIssuer
0160037081MedicaidIL
01634499OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 3467FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Orthopedic Surgery SC Past Accepting new patients
Northwest Orthopedic Surgery, S.C. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1972584464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN",
            "address_2": "SUITE 100",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055001",
            "telephone_number": "847-870-4200",
            "fax_number": "847-870-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN",
            "address_2": "SUITE 100",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055001",
            "telephone_number": "847-870-4200",
            "fax_number": "847-870-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "MALIK",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003708",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 3467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160037081",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01634499",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.