# RESURRECTION SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** RESURRECTION MEDICAL GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326336421
- **Authorized official:** DANIEL MCCORMICK (SR. VICE PRESIDENT)
- **Authorized official phone:** (708) 583-6817

## Contact information

- **Practice address:** 5645 W ADDISON ST, CHICAGO, IL 60634-4403
- **Practice address phone:** (773) 794-8314
- **Practice address fax:** (773) 527-5805
- **Mailing address:** PO BOX 564437, CHICAGO, IL 60656-4437
- **Mailing address phone:** (708) 583-7310
- **Mailing address fax:** (708) 583-9870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |

## Other

- **Enumeration date:** 07/11/2011
- **Last updated:** 07/25/2011