| Organization Name: | RESURRECTION HEALTH CARE |
| NPI Number: | 1003121658 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | OLENA GORDON (RESIDENT) |
| Mailing Address: | 2617 W Iowa St Chicago |
| State: | IL US |
| Postal Code: | 606224577 |
| Phone Number: | 2488429353 |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2010 |
| NPI Last Update Date: | 08/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |