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Organization
RESURRECTION SERVICES
Active
Organization
RESURRECTION SERVICES
Active
Other names
RAYMOND MCDONALD, MD
Organization subpart
No
Provider details
NPI number
Authorized official
LEN DEDIC (VICE PRESIDENT)
(708) 583-6818
Entity
Organization
Contact information
Practice address
1111 SUPERIOR ST, STE 307, MELROSE PARK, IL 60160-4138
(708) 343-0079
(708) 343-2488
Mailing address
1111 SUPERIOR ST, STE 307, MELROSE PARK, IL 60160-4138
(708) 343-0079
(708) 343-2488
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
999100
GROUP MEDICARE
—
Enumeration date
09/06/2006
Last updated
02/06/2008
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