Healthcare Provider Details

I. General information

NPI: 1427702679
Provider Name (Legal Business Name): TRICIA MARY URBANOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 CABOT DR
LISLE IL
60532-3711
US

IV. Provider business mailing address

4316 NUTMEG LN APT 267
LISLE IL
60532-1124
US

V. Phone/Fax

Practice location:
  • Phone: 630-864-3814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: