Provider Demographics
NPI:1639266158
Name:MALEK, GAREY ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:GAREY
Middle Name:ANDREW
Last Name:MALEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-7317
Mailing Address - Country:US
Mailing Address - Phone:847-274-1594
Mailing Address - Fax:847-516-8094
Practice Address - Street 1:114 CARY ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-2706
Practice Address - Country:US
Practice Address - Phone:847-274-1594
Practice Address - Fax:847-516-8094
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360471852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21604739OtherBLUE CROSS
IL036047185Medicaid
IL479650Medicare ID - Type Unspecified