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
3 S GREENLEAF ST, STE J, GURNEE, IL 60031-3377
(847) 599-1111
(847) 599-1148
Mailing address
3183 PAYSPHERE CIR, CHICAGO, IL 60674-3183
(708) 492-0502
(708) 492-0565
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635877
BLUE SHIELD
IL
Enumeration date
12/10/2006
Last updated
05/14/2019
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