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NPI Code Detail

MEDICARE: PAT URBANUS CNM

MEDICARE: PAT URBANUS CNM
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
1176B00000XMidwifeIL

General Provider Information

NPI Number : 1093840464
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAT URBANUS CNM
Provider Business Mailing Address
First Line : 3600 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2319
Country : US
Telephone Number : 773-782-6025
Fax Number :
Provider Business Practice Location Address
First Line : 3600 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2319
Country : US
Telephone Number : 773-782-6025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 07/08/2007

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Directions to “ PAT URBANUS CNM” Practice Location

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