Healthcare Provider Details

I. General information

NPI: 1558533596
Provider Name (Legal Business Name): CYNTHIA A URBANOWICZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3743 HIGHLAND AVE STE 1003
DOWNERS GROVE IL
60515-1594
US

IV. Provider business mailing address

1860 PAYSPHERE CIR
CHICAGO IL
60674-0018
US

V. Phone/Fax

Practice location:
  • Phone: 630-964-6049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036119336
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: