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General NPI Number Information
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NPI Number | 1144629460
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Entity Type | Organization
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Legal Business Name | URBAN HEALTHCARE INC
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 1753 W CHICAGO AVE SUITE 1
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City | CHICAGO
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State | IL
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Zip | 60622-5009
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Country | US
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Telephone | 773-672-2553
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Fax | 773-672-2559
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Provider Business Mailing Address
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Address Line | 1753 W CHICAGO AVE SUITE 1
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City | CHICAGO
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State | IL
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Zip | 60622-5009
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Country | US
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Telephone | 773-672-2553
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Fax | 773-672-2559
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Authorized Official
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Title or Position | OWNER
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Name | KHUSHAL PATL
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Credential | MD
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Telephone | 773-672-2553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 036.124097
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License Number State | IL
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