Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | IL |
NPI | 1093840464 |
---|---|
Provider Name | Pat Urbanus |
First Address | Chicago, IL 60647-2319 |
Second Address | Chicago, IL 60647-2319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |