Provider Demographics
NPI:1821262940
Name:MALHOTRA, PAULA SHAH (MD)
Entity Type:Individual
Prefix:MISS
First Name:PAULA
Middle Name:SHAH
Last Name:MALHOTRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:259 E ERIE ST
Mailing Address - Street 2:SUITE 2250
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2987
Mailing Address - Country:US
Mailing Address - Phone:312-926-6000
Mailing Address - Fax:312-926-6165
Practice Address - Street 1:259 E ERIE ST
Practice Address - Street 2:SUITE 2250
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2987
Practice Address - Country:US
Practice Address - Phone:312-926-6000
Practice Address - Fax:312-926-6165
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036129523207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036129523OtherIL LIC