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General NPI Number Information
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NPI Number | 1396239679
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Entity Type | Individual
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Provider Name | MATTHEW URBAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 1650 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3800
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Country | US
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Telephone | 443-926-4937
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Fax |
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Provider Business Mailing Address
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Address Line | 385 STATE ROUTE 24 STE 3K
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City | CHESTER
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State | NJ
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Zip | 07930-2910
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Country | US
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Telephone | 908-879-2222
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Fax | 283-205-2239
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 125072980
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 25MA12016400
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License Number State | NJ
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