Provider Demographics
NPI:1801904008
Name:MALAISRIE, S. CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:S. CHRISTOPHER
Middle Name:
Last Name:MALAISRIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SUKIT
Other - Middle Name:CHRISTOPHER
Other - Last Name:MALAISRIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:251 EAST HURON ST
Mailing Address - Street 2:GALTER 3 150
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-695-2517
Mailing Address - Fax:
Practice Address - Street 1:675 N SAINT CLAIR ST STE 19-100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5969
Practice Address - Country:US
Practice Address - Phone:312-664-3278
Practice Address - Fax:312-695-2461
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95122208G00000X
IL036105677208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZP4321ZMedicare ID - Type Unspecified
I27091Medicare UPIN