Organization
RESURRECTION SERVICES
Active
Other names
Resurrection Ambulatory Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN M. HOBSON (SYSTEM DIRECTOR)
(773) 797-3603
Entity
Organization
Contact information
Practice address
2433 NORTH HARLEM AVE, STE 100, CHICAGO, IL 60707
(773) 889-6355
(773) 355-2815
Mailing address
PO BOX 6670, RIVER FOREST, IL 60305-6670
(708) 675-8160
(708) 364-7474
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
261QR0404X
Cardiac Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619414
BCBS GRP
IL
01
—
1636085
BCBS GRP
IL
Enumeration date
07/02/2009
Last updated
10/30/2009
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