Provider Demographics
NPI:1609162627
Name:MALACHINSKI, JULIE MICHELLE (MD)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MICHELLE
Last Name:MALACHINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 HIGHLAND PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1206
Mailing Address - Country:US
Mailing Address - Phone:630-572-9393
Mailing Address - Fax:
Practice Address - Street 1:9550 W 167TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5561
Practice Address - Country:US
Practice Address - Phone:087-873-4746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.128353208000000X
FLTRN12413208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036128353Medicaid
IL036128353Medicaid