Provider Demographics
NPI:1578675708
Name:MALIEKEL, SHEILA VARGHESE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:VARGHESE
Last Name:MALIEKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:401 GREENLEAF ST
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:PARK CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60085-5744
Mailing Address - Country:US
Mailing Address - Phone:847-662-0978
Mailing Address - Fax:847-662-1395
Practice Address - Street 1:401 GREENLEAF ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:PARK CITY
Practice Address - State:IL
Practice Address - Zip Code:60085-5744
Practice Address - Country:US
Practice Address - Phone:847-662-0978
Practice Address - Fax:847-662-1395
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E74550Medicare UPIN
L77544Medicare ID - Type Unspecified