Provider Demographics
NPI:1184665028
Name:URBIN, TATIYANA M (DC)
Entity type:Individual
Prefix:DR
First Name:TATIYANA
Middle Name:M
Last Name:URBIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9801 GROSS POINT RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1173
Mailing Address - Country:US
Mailing Address - Phone:847-677-4717
Mailing Address - Fax:847-677-4717
Practice Address - Street 1:9631 GROSS POINT RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1264
Practice Address - Country:US
Practice Address - Phone:847-677-4717
Practice Address - Fax:847-677-4717
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038009006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
8168454OtherCIGNA
01625853OtherBCBS
IL038009006Medicaid
01625853OtherBCBS
U79401Medicare UPIN