Organization
VILLAGE DOCTOR, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IOURI MELNIK M.D. (PRESIDENT)
(773) 276-8600
Entity
Organization
Contact information
Practice address
809 N WESTERN AVE, CHICAGO, IL 60622-4637
(773) 276-8600
(773) 276-8601
Mailing address
809 N WESTERN AVE, CHICAGO, IL 60622-4637
(773) 276-8600
(773) 276-8601
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632565
BCBS
IL
Enumeration date
05/22/2007
Last updated
08/22/2020
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