Provider Demographics
NPI:1871849331
Name:TAILOR, URVI A (MD)
Entity Type:Individual
Prefix:DR
First Name:URVI
Middle Name:A
Last Name:TAILOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:150 FOREST AVE UNIT 914
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1452
Mailing Address - Country:US
Mailing Address - Phone:847-312-2698
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792
Practice Address - Country:US
Practice Address - Phone:608-263-8340
Practice Address - Fax:608-263-0682
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-0609322085R0202X
WI669522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology