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RESURRECTION SERVICES NPI 1326277005


NPI Information

NPI: 1326277005
Provider Name: RESURRECTION SERVICES

Doing Business As: RESURRECTION AMBULATORY CARE SERVICES

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
2433 NORTH HARLEM AVE
STE 100
CHICAGO, IL
ZIP 60707
Phone: (773) 889-6355
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RESURRECTION SERVICES is a clinic center in Chicago, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). RESURRECTION SERVICES NPI is 1326277005. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Resurrection Ambulatory Care Services.

The provider's business location address is:

2433 NORTH HARLEM AVE
STE 100
CHICAGO, IL
ZIP 60707
Phone: (773) 889-6355
Fax: (773) 355-2815

The provider's authorized official is Dean M. Hobson .
The authorized official title is System Director and has the following contact phone number (773) 797-3603.

The enumeration date for this NPI number is 7/2/2009 and was last updated on 10/30/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3261QM1200XClinic/CenterMagnetic Resonance Imaging (MRI)No
4261QM1300XClinic/CenterMulti-SpecialtyNo
5261QR0200XClinic/CenterRadiologyNo
6261QR0206XClinic/CenterRadiology, MammographyNo
7261QR0404XClinic/CenterRehabilitation, Cardiac FacilitiesNo
8261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1917350MEDICARE PINILLINOIS
21619414OTHERILLINOISBCBS GRP
3=========6030501MEDICAIDILLINOIS
4IL2091MEDICARE PINILLINOIS
5739531MEDICARE PINILLINOIS
61636085OTHERILLINOISBCBS GRP
7IL1390MEDICARE PINILLINOIS
8216966MEDICARE PINILLINOIS
9IL1864MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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