Provider Demographics
NPI:1154487957
Name:UROPARTNERS, LLC
Entity Type:Organization
Organization Name:UROPARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-450-5055
Mailing Address - Street 1:7900 N MILWAUKEE AVE
Mailing Address - Street 2:STE 17
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3159
Mailing Address - Country:US
Mailing Address - Phone:847-470-1500
Mailing Address - Fax:847-470-1550
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:STE. 509
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-775-0800
Practice Address - Fax:847-823-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01619727OtherBLUE SHIELD
ILDE0395OtherRAILROAD MEDICARE
IL01619727OtherBLUE SHIELD
IL212223Medicare PIN