MEDICARE: RESURRECTION PHYSICIANS PROVIDER GROUP

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
1	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1740361021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESURRECTION PHYSICIANS PROVIDER GROUP

Provider Business Mailing Address
First Line	:	5860 W HIGGINS AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2372
Country	:	US
Telephone Number	:	773-695-4800
Fax Number	:	773-864-9416

Provider Business Practice Location Address
First Line	:	5860 W HIGGINS AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2372
Country	:	US
Telephone Number	:	773-695-4800
Fax Number	:	773-864-9416

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MS. DARA C. ELLINGSON
Credential	:
Telephone Number	:	773-527-5210

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	04/01/2010

Similar Medicare Providers

1619236072 — NEIGHBORHOOD HEALTH GROUP, LLC
Practice Location Address:

5860 W HIGGINS AVE
CHICAGO, IL
60630-2372

Practice Phone: 773-695-4800
Practice Fax:

1538663679 — MSO GREAT LAKES, INC.
Practice Location Address:

5860 W HIGGINS AVE
CHICAGO, IL
60630-2372

Practice Phone: 773-695-4800
Practice Fax: 773-864-9418

1972724821 — BETH A KELLEY NP, CNM
Practice Location Address:

1717 E. CHICAGO ROAD
STURGIS, MI
49091-2372

Practice Phone: 269-659-6747
Practice Fax: 269-659-6746

1356537278 — SAMUELS CARE CENTER S C
Practice Location Address:

1130 S WABASH AVE , SUITE 305
CHICAGO, IL
60605-2372

Practice Phone: 312-212-1159
Practice Fax: 312-212-1184

1609045723 — MS. CASSANDRA HOWARD LCPC
Practice Location Address:

1130 S WABASH AVE
CHICAGO, IL
60605-2372

Practice Phone: 773-484-0854
Practice Fax:

1740429968 — UNIVERSITY DENTAL ASSOCIATES
Practice Location Address:

1 E SCOTT ST
CHICAGO, IL
60610-2372

Practice Phone: 312-337-0004
Practice Fax:

Directions to “RESURRECTION PHYSICIANS PROVIDER GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.