Provider Demographics
NPI:1689551467
Name:ADDISON FAMILY MEDICINE LTD.
Entity type:Organization
Organization Name:ADDISON FAMILY MEDICINE LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:BAGCAL
Authorized Official - Last Name:URBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-729-7668
Mailing Address - Street 1:7400 W ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-3418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7400 W ADDISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-3418
Practice Address - Country:US
Practice Address - Phone:773-625-1900
Practice Address - Fax:773-625-5348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty