Amanda Marie Urban, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

71007034 Issued in IL

Practice address

5TH Ave. and Roosevelt
Hines, IL 60141

Phone

(708) 202-2682

Fax

(708) 202-2687

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mandy Urban/ Grant Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1285714535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 S. ROOSEVELT ROAD",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601419135",
            "telephone_number": "708-202-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5TH AVE. AND ROOSEVELT",
            "city": "HINES",
            "state": "IL",
            "postal_code": "60141",
            "telephone_number": "708-202-2682",
            "fax_number": "708-202-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAN",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71007034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "URBAN/ GRANT",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Saruul Tsogtbayar, PHARMD
• Kamala Tummala, M.D.
• Jill E Turkoglu, NP
• Christine Lomey Ulinski, AU.D.
• Raj Bahadur Uppal, MD
• Robert Urnikis
• Russell Eugene Usauskas, PHARMD.
• Joe Vadakara, PHARMD
• Molly J Vadakara, CRNA
• Alexi Vahlkamp

• Clinical Psychologist in Hines, IL
• Providers in Hines, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.