Provider Demographics
NPI:1366685232
Name:RESURRECTION MEDICAL CENTER
Entity Type:Organization
Organization Name:RESURRECTION MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL TORO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-813-3040
Mailing Address - Street 1:7435 WEST TALCOTT
Mailing Address - Street 2:NEW BEGINNINGS PRENATAL PROGRAM
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631
Mailing Address - Country:US
Mailing Address - Phone:847-813-3040
Mailing Address - Fax:847-813-3036
Practice Address - Street 1:7435 W TALCOTT AVE
Practice Address - Street 2:NEW BEGINNINGS
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3707
Practice Address - Country:US
Practice Address - Phone:847-813-3040
Practice Address - Fax:847-813-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty