Healthcare Provider Details

I. General information

NPI: 1801258868
Provider Name (Legal Business Name): RYAN PAUL BAGCAL URBI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 W ADDISON ST
CHICAGO IL
60634-3418
US

IV. Provider business mailing address

433 GILBERT DR
WOOD DALE IL
60191-1942
US

V. Phone/Fax

Practice location:
  • Phone: 773-625-1900
  • Fax:
Mailing address:
  • Phone: 808-729-7668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036175353
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS3329
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: