Provider Demographics
NPI:1477648566
Name:URO SURGERY ASSOCIATES LLC
Entity Type:Organization
Organization Name:URO SURGERY ASSOCIATES LLC
Other - Org Name:UROLOGIC SPECIALISTS OF NORTHWEST INDIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:YALOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-736-1255
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-0697
Mailing Address - Country:US
Mailing Address - Phone:708-228-5542
Mailing Address - Fax:214-613-0153
Practice Address - Street 1:400 W 84TH DR.
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6248
Practice Address - Country:US
Practice Address - Phone:219-736-1255
Practice Address - Fax:219-738-1276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID #