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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
1251E00000XHome Health Agency1010210IL

General Provider Information

NPI Number : 1063513109
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESURRECTION SERVICES
Provider Business Mailing Address
First Line : 5747 DEMPSTER ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-3056
Country : US
Telephone Number : 847-568-8542
Fax Number : 847-568-8635
Provider Business Practice Location Address
First Line : 5747 DEMPSTER ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-3056
Country : US
Telephone Number : 847-568-8542
Fax Number : 847-568-8635
Authorized Official
Title or Position : CONTROLLER
Name : THOMAS L GALLUPPI
Credential :
Telephone Number : 847-568-8524
Provider Enumeration Date : 09/25/2006
Last Update Date : 09/18/2007

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Directions to “RESURRECTION SERVICES ” Practice Location

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