MEDICARE: UROPARTNERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DD7289	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01635877	OTHER		BCBS

General Provider Information

NPI Number	:	1356395321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROPARTNERS, LLC

Provider Business Mailing Address
First Line	:	5215 N CALIFORNIA AVE
Second Line	:	STE. F803
City	:	CHICAGO
State	:	IL
Zip	:	60625-7014
Country	:	US
Telephone Number	:	773-878-7555
Fax Number	:	773-878-8545

Provider Business Practice Location Address
First Line	:	5215 N CALIFORNIA AVE
Second Line	:	STE. F803
City	:	CHICAGO
State	:	IL
Zip	:	60625-7014
Country	:	US
Telephone Number	:	773-878-7555
Fax Number	:	773-878-8545

Authorized Official
Title or Position	:	AUTHORIZED REPRESENTATIVE
Name	:	RICHARD HARRIS
Credential	:	MD
Telephone Number	:	708-450-5055

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	10/27/2015

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Directions to “UROPARTNERS, LLC ” Practice Location

Language	Start Address	Practice Location

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