Active NPI
Village Doctor, LTD
- Primary Care Clinic/Center
- Chicago, IL
National Provider Identifier
1982814992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- VILLAGE DOCTOR, LTD
- Practice address
- 809 N Western Ave
Chicago, IL 60622-4637 - Phone
- (773) 276-8600
- Fax
- (773) 276-8601
- NPI assigned
- May 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Iouri Melnik, M.D.
- Title
- President
- Phone
- (773) 276-8600
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | IL | Primary |
Addresses
Primary practice location
809 N Western Ave
Chicago, IL 60622-4637
Mailing address
809 N Western Ave
Chicago, IL 60622-4637
Phone (773) 276-8600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01632565 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2323 W Chicago Ave
Chicago, IL 60622
Phone (773) 276-2110
Interoperability endpoints
- https://api.platform.athenahealth.com/7709/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Chicago, IL
- NPI 1235113747
-
- Family Nurse Practitioner
- Chicago, IL
- NPI 1720451099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1982814992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 N WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606224637",
"telephone_number": "773-276-8600",
"fax_number": "773-276-8601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 N WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606224637",
"telephone_number": "773-276-8600",
"fax_number": "773-276-8601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE DOCTOR, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-22",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MELNIK",
"authorized_official_first_name": "IOURI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "773-276-8600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "01632565",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.