Provider Demographics
NPI:1023085941
Name:MALIK, AMAAR MASOOD (DO)
Entity type:Individual
Prefix:
First Name:AMAAR
Middle Name:MASOOD
Last Name:MALIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5495 S RAINBOW BLVD
Mailing Address - Street 2:#101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118
Mailing Address - Country:US
Mailing Address - Phone:702-891-9729
Mailing Address - Fax:702-898-0223
Practice Address - Street 1:801 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7430
Practice Address - Country:US
Practice Address - Phone:630-527-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12392085R0202X
AZ42992085R0202X
CA20A87102085R0202X
IL036-1193132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506970Medicaid
IL036-119313OtherSTATE LICENSE
NV100506970Medicaid