Provider Demographics
NPI:1396801197
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 1:7900 N MILWAUKEE AVE
Mailing Address - Street 2:STE 17
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3159
Mailing Address - Country:US
Mailing Address - Phone:847-470-1500
Mailing Address - Fax:847-470-1550
Practice Address - Street 1:1875 DEMPSTER ST
Practice Address - Street 2:STE 506
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1186
Practice Address - Country:US
Practice Address - Phone:847-823-4700
Practice Address - Fax:847-823-4715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDE0395OtherRAILROAD MEDICARE
IL01619727OtherBLUE SHIELD
IL5514060015Medicare NSC
ILDE0395OtherRAILROAD MEDICARE