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Organization
PRESENCE HEALTHCARE SERVICES
Active
Organization
PRESENCE HEALTHCARE SERVICES
Active
Other names
Resurrection Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELVONNE WICKLIFFE-JONES (CREDENTIALING MGR)
(630) 914-2417
Entity
Organization
Contact information
Practice address
800 AUSTIN ST, SUITE #451 EAST TOWER, EVANSTON, IL 60202-3439
(847) 316-6611
(847) 316-6606
Mailing address
1000 REMINGTON BOULEVARD, BOLINGBROOK, IL 60440-0000
(630) 914-2417
(630) 914-2499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042217
—
IL
05
—
036113363
—
IL
Enumeration date
09/06/2006
Last updated
04/09/2013
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