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NPI Code Detail

MEDICARE: ANDRIY VICTOR HAVRYLYAN

MEDICARE: ANDRIY VICTOR HAVRYLYAN
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
1207R00000XInternal Medicine Physician036.145751IL
2207RE0101XEndocrinology, Diabetes & Metabolism Physician036.145751IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730560517
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRIY VICTOR HAVRYLYAN
Provider Business Mailing Address
First Line : 1500 S FAIRFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1782
Country : US
Telephone Number : 773-257-2069
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S FAIRFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1782
Country : US
Telephone Number : 773-542-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2015
Last Update Date : 03/02/2026

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Directions to “ ANDRIY VICTOR HAVRYLYAN ” Practice Location

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