Healthcare Provider Details

I. General information

NPI: 1821353707
Provider Name (Legal Business Name): UROOSA KAMRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2012
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3249 S. OAK PARK AVENUE MACNEAL HOSPITAL
BERWYN IL
60402
US

IV. Provider business mailing address

1 WESTBROOK CORPORATE CTR STE 8401
WESTCHESTER IL
60154-5701
US

V. Phone/Fax

Practice location:
  • Phone: 708-783-9100
  • Fax:
Mailing address:
  • Phone: 708-783-9100
  • Fax: 708-783-0327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125062124
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: