Organization
ASSOCIATED UROLOGICAL SPECIALISTS LLC
Active
Other names
Midwest Urology-Evergreen Park
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZA ROQUE (DIRECTOR)
(708) 608-2195
Entity
Organization
Contact information
Practice address
2850 W 95TH ST, EVERGREEN PARK, IL 60805-2735
(708) 422-2242
Mailing address
10400 SOUTHEST HIGHWAY, LOWER LEVEL, CHICAGO RIDGE, IL 60415
(708) 581-7308
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
02/09/2007
Last updated
03/18/2020
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