Organization
UROLOGY ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER KENT RIVES MD (OWNER/MD)
(217) 258-4186
Entity
Organization
Contact information
Practice address
500 HEALTH CENTER DR, SUITE 305, MATTOON, IL 61938-9258
(217) 258-4186
(217) 258-4185
Mailing address
500 HEALTH CENTER DR, SUITE 305, MATTOON, IL 61938-9258
(217) 258-4186
(217) 258-4185
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
IL
363A00000X
Physician Assistant
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L58333
MEDICARE PIN #
IL
Enumeration date
08/03/2006
Last updated
09/11/2025
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