Provider Demographics
NPI:1982693370
Name:MALHOTRA, RAJAT (MD)
Entity Type:Individual
Prefix:
First Name:RAJAT
Middle Name:
Last Name:MALHOTRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25070 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1250
Mailing Address - Country:US
Mailing Address - Phone:847-585-7000
Mailing Address - Fax:847-240-0622
Practice Address - Street 1:880 W CENTRAL RD STE 8200
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2380
Practice Address - Country:US
Practice Address - Phone:847-259-4482
Practice Address - Fax:847-259-6406
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095434207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095434Medicaid
ILH50838Medicare UPIN
IL355031003Medicare PIN
ILL84702Medicare ID - Type Unspecified
ILP00930978Medicare PIN
IL632020004Medicare PIN
IL036095434Medicaid