Provider Demographics
NPI:1871545400
Name:BILYK, IHOR
Entity type:Individual
Prefix:
First Name:IHOR
Middle Name:
Last Name:BILYK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HIGHVIEW RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966-2209
Mailing Address - Country:US
Mailing Address - Phone:260-348-6235
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT547802080N0001X
IN01042406A2080N0001X
WI64570-202080N0001X
MA2343462080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH979197Medicaid
MA110077701AMedicaid
000000111852OtherBC BS PIN
MI4229859Medicaid
IN100368270AMedicaid
C6628001OtherCSHCS