Provider Demographics
NPI:1831103621
Name:MALEK, ROBERT BEHRENDT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BEHRENDT
Last Name:MALEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BIESTERFIELD RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3392
Mailing Address - Country:US
Mailing Address - Phone:847-545-9930
Mailing Address - Fax:847-545-9937
Practice Address - Street 1:901 BIESTERFIELD RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3392
Practice Address - Country:US
Practice Address - Phone:847-545-9930
Practice Address - Fax:847-545-9937
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19-0160601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice