Provider Demographics
NPI:1952557316
Name:BALEK, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:BALEK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:808 E WOODFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4836
Mailing Address - Country:US
Mailing Address - Phone:847-605-0030
Mailing Address - Fax:847-637-0737
Practice Address - Street 1:7035 NORTH AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1015
Practice Address - Country:US
Practice Address - Phone:708-680-3800
Practice Address - Fax:708-383-3665
Is Sole Proprietor?:No
Enumeration Date:2008-08-16
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036138469207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036138469Medicaid
ILF400276496Medicare PIN
NY03241389Medicaid
IL036138469Medicaid