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NORTH IDAHO UROLOGY, P.L.L.C.

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Company Details

Name: NORTH IDAHO UROLOGY, P.L.L.C.
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Jul 2001 (24 years ago)
Financial Date End: 31 Jul 2026
Entity Number: 62047
Place of Formation: IDAHO
File Number: 62047
ZIP code: 83814
County: Kootenai County
Principal Address: 980 W IRONWOOD DR STE 104 COEUR D ALENE, ID 83814
Mailing Address: STE 104 980 W IRONWOOD DR COEUR D ALENE, ID 83814-2668

Agent

Name Role Address
Chad Peterson Agent 980 W IRONWOOD DRIVE SUITE 104, COEUR D ALENE, ID 83814

Member

Name Role Address Appointed On Resigned On
EDWARD ELLISON MD Member 980 W IRONWOOD DR STE 104, COEUR D ALENE, ID 83814 2021-05-20 No data
RANDI L CLARK MD Member 980 W IRONWOOD DR STE 104, COEUR D ALENE, ID 83814 2024-06-03 2024-06-03

Manager

Name Role Address Appointed On Resigned On
MICHELLE K FROEHLICH Manager 980 W IRONWOOD DR STE 104, COEURD'ALENE, ID 83814 2024-06-03 2024-06-03

National Provider Identifier

NPI Number:
1891834768
Certification Date:
2024-07-17

Authorized Person:

Name:
CHRISTINE A CHATFIELD
Role:
BILLING SUPERVISOR
Phone:

Taxonomy:

Selected Taxonomy:
208800000X - Urology Physician
Is Primary:
Yes

Contacts:

Fax:
2086641709

Form 5500 Series

Employer Identification Number (EIN):
820533076
Plan Year:
2023
Number Of Participants:
42
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
42
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
38
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
32
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
28
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006354990 2025-07-11
Annual Report 0005754910 2024-06-03
Annual Report 0005754897 2024-06-03
Change of Registered Office/Agent/Both (by Entity) 0005450969 2023-10-27
Change of Registered Office/Agent/Both (by Entity) 0005450972 2023-10-27

Paycheck Protection Program

Jobs Reported:
27
Initial Approval Amount:
$725,000
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$725,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$732,806.16
Servicing Lender:
Glacier Bank
Use of Proceeds:
Payroll: $725,000

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Date of last update: 29 Jul 2025

Sources: Idaho Secretary of State