Malabanan, Raquel

Malabanan, Raquel is an individual health care provider with primary practice located at 1200 W State St , Rockford IL 61102-2112. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Malabanan, Raquel can be contacted via phone (815) 490-1600.

Contact Information

Primary practice address
1200 W State St Rockford IL 61102-2112
Phone: (815) 490-1600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036091422 Illinois

Profile Details

NPI number 1326021361
LBN Legal business name Malabanan, Raquel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Jan 25th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326021361 NPPES
Illinois MEDICAID 036091422

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