Organization
UROPARTNERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G HARRIS MD (AUTHORIZED REPRESENTATIVE)
(708) 450-5055
Entity
Organization
Contact information
Practice address
1875 DEMPSTER ST, STE 506, PARK RIDGE, IL 60068-1186
(847) 823-4700
(847) 823-4715
Mailing address
7900 N MILWAUKEE AVE, STE 17, NILES, IL 60714-3159
(847) 470-1500
(847) 470-1550
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619727
BLUE SHIELD
IL
01
—
DE0395
RAILROAD MEDICARE
IL
Enumeration date
12/28/2006
Last updated
05/10/2011
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