Provider Demographics
NPI:1700263282
Name:URAM, EDWARD ANTHONY III (DPM)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ANTHONY
Last Name:URAM
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1228 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2740
Mailing Address - Country:US
Mailing Address - Phone:630-810-9966
Mailing Address - Fax:630-810-9596
Practice Address - Street 1:1228 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2740
Practice Address - Country:US
Practice Address - Phone:630-810-9966
Practice Address - Fax:630-810-9596
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005816213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery