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NPI Code Detail

MEDICARE: KELLEEN M URBON

MEDICARE: KELLEEN M URBON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor180-000218IL

General Provider Information

NPI Number : 1073514774
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEEN M URBON
Provider Business Mailing Address
First Line : 1120 E MAIN ST
Second Line : STE. 201
City : ST CHARLES
State : IL
Zip : 60174-2287
Country : US
Telephone Number : 630-377-6613
Fax Number : 630-377-6225
Provider Business Practice Location Address
First Line : 110 E COUNTRYSIDE PKWY
Second Line :
City : YORKVILLE
State : IL
Zip : 60560-1813
Country : US
Telephone Number : 630-553-1600
Fax Number : 630-553-7993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 01/27/2010

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Directions to “ KELLEEN M URBON ” Practice Location

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