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Organization
RESURRECTION SERVICES
Active
Organization
RESURRECTION SERVICES
Active
Other names
DEREK R OLSON DO
Organization subpart
No
Provider details
NPI number
Authorized official
LEN DEDIC (VICE PRESIDENT)
(708) 583-6818
Entity
Organization
Contact information
Practice address
5113 N CLARK ST, CHICAGO, IL 60640-2807
(773) 271-2050
(773) 271-0911
Mailing address
5113 N CLARK ST, CHICAGO, IL 60640-2807
(773) 271-2050
(773) 271-0911
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211982
MEDICARE GROUP
IL
Enumeration date
08/24/2006
Last updated
10/26/2007
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