Provider Demographics
NPI:1356395321
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:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-450-5055
Mailing Address - Street 1:5215 N CALIFORNIA AVE
Mailing Address - Street 2:STE. F803
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-7014
Mailing Address - Country:US
Mailing Address - Phone:773-878-7555
Mailing Address - Fax:773-878-8545
Practice Address - Street 1:5215 N CALIFORNIA AVE
Practice Address - Street 2:STE. F803
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-7014
Practice Address - Country:US
Practice Address - Phone:773-878-7555
Practice Address - Fax:773-878-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01635877OtherBCBS
ILDD7289OtherRAILROAD MEDICARE
01635877OtherBCBS
212213Medicare PIN
214706Medicare PIN