Provider Demographics
NPI:1184882789
Name:MELNYTSKYY, IHOR V (MD)
Entity type:Individual
Prefix:DR
First Name:IHOR
Middle Name:V
Last Name:MELNYTSKYY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 SANDGATE CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2306
Mailing Address - Country:US
Mailing Address - Phone:630-946-6885
Mailing Address - Fax:864-455-1320
Practice Address - Street 1:300 SINGLETON RIDGE ROAD
Practice Address - Street 2:CONWAY MEDICAL CENTER
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526
Practice Address - Country:US
Practice Address - Phone:843-347-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI81569207L00000X
SCTL30811207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100228786Medicaid