Provider Demographics
NPI:1760503700
Name:UROCARE LLC
Entity Type:Organization
Organization Name:UROCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERROLD
Authorized Official - Middle Name:H
Authorized Official - Last Name:SECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-259-2410
Mailing Address - Street 1:880 W CENTRAL RD
Mailing Address - Street 2:SUITE 5200
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2355
Mailing Address - Country:US
Mailing Address - Phone:847-259-2410
Mailing Address - Fax:847-259-8603
Practice Address - Street 1:880 W CENTRAL RD
Practice Address - Street 2:SUITE 5200
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2355
Practice Address - Country:US
Practice Address - Phone:847-259-2410
Practice Address - Fax:847-259-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1615843OtherBLUE CROSS BLUE SHIELD
IL=========Medicaid
IL=========Medicaid