Organization
RESURRECTION SERVICES
Active
Other names
RESURRECTION MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MCCORMICK (SR. VICE PRESIDENT)
(708) 583-6817
Entity
Organization
Contact information
Practice address
5645 W ADDISON ST, CHICAGO, IL 60634-4403
(773) 794-8314
(773) 527-5805
Mailing address
PO BOX 564437, CHICAGO, IL 60656-4437
(708) 583-7310
(708) 583-9870
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Enumeration date
07/11/2011
Last updated
07/25/2011
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