Provider Demographics
NPI:1407064777
Name:AFFILIATED UROLOGISTS LTD
Entity Type:Organization
Organization Name:AFFILIATED UROLOGISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCKIEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:847-234-3300
Mailing Address - Street 1:900 N WESTMORELAND RD
Mailing Address - Street 2:128
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1674
Mailing Address - Country:US
Mailing Address - Phone:847-234-3300
Mailing Address - Fax:
Practice Address - Street 1:900 N WESTMORELAND RD
Practice Address - Street 2:128
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1674
Practice Address - Country:US
Practice Address - Phone:847-234-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty