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NPI Code Detail

MEDICARE: RESURRECTION SERVICES

MEDICARE: RESURRECTION SERVICES
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1487928198
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESURRECTION SERVICES
Provider Business Mailing Address
First Line : 62311 COLLECTION CENTER DR
Second Line :
City : CHICAGO
State : IL
Zip : 60693-0623
Country : US
Telephone Number : 800-273-2614
Fax Number :
Provider Business Practice Location Address
First Line : 525 WINNETKA AVE
Second Line : SUITE B
City : WINNETKA
State : IL
Zip : 60093-4050
Country : US
Telephone Number : 847-446-1112
Fax Number : 847-446-1717
Authorized Official
Title or Position : SENIOR VICE PRESIDENT
Name : DANIEL MCCORMICK
Credential :
Telephone Number : 708-583-6817
Provider Enumeration Date : 02/27/2012
Last Update Date : 02/27/2012

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Directions to “RESURRECTION SERVICES ” Practice Location

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