Provider Demographics
NPI:1538347406
Name:UROPARTNERS LLC
Entity type:Organization
Organization Name:UROPARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-492-0502
Mailing Address - Street 1:3183 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0031
Mailing Address - Country:US
Mailing Address - Phone:708-492-0502
Mailing Address - Fax:708-492-0565
Practice Address - Street 1:6440 GRAND AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5257
Practice Address - Country:US
Practice Address - Phone:847-782-8349
Practice Address - Fax:847-782-8546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1912923269OtherTYPE 1 NPI
IL1912923269OtherTYPE 1 NPI
ILK05553Medicare UPIN