Provider Demographics
NPI:1518027812
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:G
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-450-5055
Mailing Address - Street 1:3183 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-3183
Mailing Address - Country:US
Mailing Address - Phone:708-492-0502
Mailing Address - Fax:708-492-0565
Practice Address - Street 1:3 S GREENLEAF ST
Practice Address - Street 2:STE J
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3377
Practice Address - Country:US
Practice Address - Phone:847-599-1111
Practice Address - Fax:847-599-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-10
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635877OtherBLUE SHIELD
IL01635877OtherBLUE SHIELD
5514060031Medicare NSC