Provider Demographics
NPI:1871783555
Name:UHL, JUSTIN NELSON (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:NELSON
Last Name:UHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:737 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2615
Mailing Address - Country:US
Mailing Address - Phone:312-951-5800
Mailing Address - Fax:312-951-5813
Practice Address - Street 1:737 N MICHIGAN AVE
Practice Address - Street 2:SUITE 900
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2615
Practice Address - Country:US
Practice Address - Phone:312-951-5800
Practice Address - Fax:312-951-5813
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-097596208000000X
IL036-130145208000000X, 2080P0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0050031Medicaid
OHH006280Medicare PIN