Provider Demographics
NPI:1497896971
Name:ASSOCIATED UROLOGICAL SPECIALISTS LLC
Entity Type:Organization
Organization Name:ASSOCIATED UROLOGICAL SPECIALISTS LLC
Other - Org Name:CHARLES O. TURK, D.O.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-608-2195
Mailing Address - Street 1:10400 SOUTHWEST HWY
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-1367
Mailing Address - Country:US
Mailing Address - Phone:708-581-7308
Mailing Address - Fax:708-274-4027
Practice Address - Street 1:15234 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4330
Practice Address - Country:US
Practice Address - Phone:708-633-4544
Practice Address - Fax:708-614-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
211475Medicare PIN
C49098Medicare UPIN
5433040008Medicare NSC