Healthcare Provider Details

I. General information

NPI: 1467471540
Provider Name (Legal Business Name): UROPARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 SOUTHWEST HWY
CHICAGO RIDGE IL
60415-1367
US

IV. Provider business mailing address

29661 NETWORK PL
CHICAGO IL
60673-1296
US

V. Phone/Fax

Practice location:
  • Phone: 708-336-7701
  • Fax: 708-336-7710
Mailing address:
  • Phone: 708-923-2400
  • Fax: 708-923-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: RICHARD GERALD HARRIS
Title or Position: CEO
Credential: MD
Phone: 708-450-5055