Provider Demographics
NPI:1710020052
Name:UROHEALTH INSTITUTE, L.L.C.
Entity type:Organization
Organization Name:UROHEALTH INSTITUTE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNETT
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-888-4000
Mailing Address - Street 1:2005 JACOBSSEN DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-6279
Mailing Address - Country:US
Mailing Address - Phone:309-888-4000
Mailing Address - Fax:309-888-4144
Practice Address - Street 1:2005 JACOBSSEN DR
Practice Address - Street 2:SUITE A
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-6279
Practice Address - Country:US
Practice Address - Phone:309-888-4000
Practice Address - Fax:309-888-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical