Organization
UROLOGICAL ASSOCIATES OF BELLEVILLE IL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS JEROME STANCZYK M.D. (PRESIDENT)
(618) 233-2603
Entity
Organization
Contact information
Practice address
301 W LINCOLN ST STE 57, BELLEVILLE, IL 62220-1901
(618) 233-2603
(618) 233-0413
Mailing address
301 W LINCOLN ST STE 57, BELLEVILLE, IL 62220-1901
(618) 233-2603
(618) 233-0413
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
289630
MEDICARE GROUP NUMBER
IL
Enumeration date
10/12/2006
Last updated
09/25/2007
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