Provider Demographics
NPI:1144629460
Name:URBAN HEALTHCARE INC
Entity type:Organization
Organization Name:URBAN HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHUSHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-672-2553
Mailing Address - Street 1:1753 W CHICAGO AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5009
Mailing Address - Country:US
Mailing Address - Phone:773-672-2553
Mailing Address - Fax:773-672-2559
Practice Address - Street 1:1753 W CHICAGO AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5009
Practice Address - Country:US
Practice Address - Phone:773-672-2553
Practice Address - Fax:773-672-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1240972086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty