# RESURRECTION SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Resurrection Ambulatory Care Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326277005
- **Authorized official:** DEAN M. HOBSON (SYSTEM DIRECTOR)
- **Authorized official phone:** (773) 797-3603

## Contact information

- **Practice address:** 2433 NORTH HARLEM AVE, STE 100, CHICAGO, IL 60707
- **Practice address phone:** (773) 889-6355
- **Practice address fax:** (773) 355-2815
- **Mailing address:** PO BOX 6670, RIVER FOREST, IL 60305-6670
- **Mailing address phone:** (708) 675-8160
- **Mailing address fax:** (708) 364-7474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |
| 261QR0206X | Mammography Clinic/Center | — | NULL | — |
| 261QR0404X | Cardiac Rehabilitation Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/02/2009
- **Last updated:** 10/30/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1619414 | BCBS GRP | IL |
| 01 | — | 1636085 | BCBS GRP | IL |
