Provider Demographics
NPI:1457468092
Name:ASSOCIATE PATHOLOGISTS OF JOLIET LTD
Entity Type:Organization
Organization Name:ASSOCIATE PATHOLOGISTS OF JOLIET LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LORON
Authorized Official - Last Name:URBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-725-7222
Mailing Address - Street 1:333 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8200
Mailing Address - Country:US
Mailing Address - Phone:815-725-7222
Mailing Address - Fax:815-773-7037
Practice Address - Street 1:333 MADISON ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8200
Practice Address - Country:US
Practice Address - Phone:815-725-7222
Practice Address - Fax:815-773-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042-000066207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL366889700OtherUS DEPARTMENT OF LABOR - AURORA
IL130765700OtherUS DEPARTMENT OF LABOR - JOLIET
IL610560Medicare PIN
IL130765700OtherUS DEPARTMENT OF LABOR - JOLIET