Provider Demographics
NPI:1285688218
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:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-450-5055
Mailing Address - Street 1:1800 HOLLISTER DR STE 107
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5265
Mailing Address - Country:US
Mailing Address - Phone:847-295-0010
Mailing Address - Fax:847-549-7815
Practice Address - Street 1:1800 HOLLISTER DR STE 107
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5265
Practice Address - Country:US
Practice Address - Phone:847-295-0010
Practice Address - Fax:847-549-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDE9922OtherRAILROAD MEDICARE
01635877OtherBCBS
IL5514060007Medicare NSC
212212Medicare PIN