Provider Demographics
NPI:1356352058
Name:VOLODYMYR
Entity type:Organization
Organization Name:VOLODYMYR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VOLODYMYR
Authorized Official - Middle Name:
Authorized Official - Last Name:MELNYCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:DN
Authorized Official - Phone:773-282-5409
Mailing Address - Street 1:5856 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2622
Mailing Address - Country:US
Mailing Address - Phone:773-282-5409
Mailing Address - Fax:773-282-3868
Practice Address - Street 1:5856 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2622
Practice Address - Country:US
Practice Address - Phone:773-282-5409
Practice Address - Fax:773-282-3868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632433OtherNAPRAPATH