Organization Name: | RESURRECTION SERVICES |
NPI Number: | 1083926661 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEAN M. HOBSON (SYSTEM DIRECTOR) |
Mailing Address: | 4900 N Cumberland Ave Suite 200 Norridge |
State: | IL US |
Postal Code: | 607062916 |
Phone Number: | 7084561600 |
Fax Number: | 7084562809 |
NPI Enumeration Date: | 07/12/2010 |
NPI Last Update Date: | 07/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |