Provider Demographics
NPI:1699158378
Name:MALKOWSKI, MALGORZATA ELZIETA
Entity type:Individual
Prefix:MRS
First Name:MALGORZATA
Middle Name:ELZIETA
Last Name:MALKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 W WRIGHTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-1624
Mailing Address - Country:US
Mailing Address - Phone:708-224-5993
Mailing Address - Fax:
Practice Address - Street 1:7214 W WRIGHTWOOD AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-1624
Practice Address - Country:US
Practice Address - Phone:708-224-5993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program