Basic Information
| Provider Information | |||||||||
| NPI: | 1295726115 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UROPARTNERS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1660 FEEHANVILLE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | MOUNT PROSPECT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600566036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478233185 | ||||||||
| FaxNumber: | 8478233318 | ||||||||
| Practice Location | |||||||||
| Address1: | 1660 FEEHANVILLE DR | ||||||||
| Address2: | STE 200 | ||||||||
| City: | MOUNT PROSPECT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478233185 | ||||||||
| FaxNumber: | 8478233318 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7084505055 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 208800000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 01635877 | 01 | BCBS | OTHER |