Provider Demographics
NPI:1851656276
Name:MALEK, ANITA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:MALEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5666 E STATE ST
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY AND LAB MEDICINE
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108
Mailing Address - Country:US
Mailing Address - Phone:815-395-5108
Mailing Address - Fax:815-227-2450
Practice Address - Street 1:5666 E STATE ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY AND LAB MEDICINE
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108
Practice Address - Country:US
Practice Address - Phone:815-395-5108
Practice Address - Fax:815-227-2450
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA273215207ZP0102X
MA253287207ZP0102X
IL036.147933207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology