Associated Urological Specialists LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

ASSOCIATED UROLOGICAL SPECIALISTS LLC

Practice address

2850 W 95TH St
Evergreen Park, IL 60805-2735

Phone

(708) 422-2242

NPI assigned

Feb 9, 2007

Last updated

Mar 18, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eliza Roque

Title

Director

Phone

(708) 608-2195

Specialties & licenses 1

Addresses

Other names 1

• Midwest Urology-Evergreen Park Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1306987896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 SOUTHEST HIGHWAY",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "60415",
            "telephone_number": "708-581-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-422-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED UROLOGICAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "ROQUE",
        "authorized_official_first_name": "ELIZA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-608-2195"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Urology-Evergreen Park",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Midwest Urology-Evergreen Park",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Urology Physician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.