Organization
UROPARTNERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD HARRIS MD (AUTHORIZED REPRESENTATIVE)
(708) 450-5055
Entity
Organization
Contact information
Practice address
2600 PATRIOT BLVD, STE. J, GLENVIEW, IL 60026-8024
(224) 260-3100
Mailing address
2245 ENTERPRISE DR, SUITE 4506, WESTCHESTER, IL 60154
(708) 492-0502
(708) 492-0565
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208800000X
Urology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635877
BLUE SHIELD
IL
01
—
DE5300
RAILROAD MEDICARE
IL
Enumeration date
05/22/2006
Last updated
05/14/2019
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