Provider Demographics
NPI:1629449053
Name:URBANCARE, LLC
Entity Type:Organization
Organization Name:URBANCARE, LLC
Other - Org Name:PREMIER HEALTH SPECIALISTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:W
Authorized Official - Last Name:URBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-569-4000
Mailing Address - Street 1:170 NORTH LAKEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-5945
Mailing Address - Country:US
Mailing Address - Phone:224-569-4000
Mailing Address - Fax:877-686-5642
Practice Address - Street 1:170 NORTH LAKEWOOD ROAD
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-5945
Practice Address - Country:US
Practice Address - Phone:224-569-4000
Practice Address - Fax:877-686-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty