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NPI Code Detail

MEDICARE: MR. IOURI MELNIK M.D.

MEDICARE:  MR. IOURI  MELNIK  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036094506IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101632565OTHERILBCBS ILLINOIS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235113747
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. IOURI MELNIK M.D.
Provider Business Mailing Address
First Line : 2323 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4723
Country : US
Telephone Number : 773-276-8600
Fax Number : 773-276-8601
Provider Business Practice Location Address
First Line : 2323 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4723
Country : US
Telephone Number : 773-276-8600
Fax Number : 773-276-8601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 08/25/2016

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