Provider Demographics
NPI:1942985270
Name:RESURRECTION HOME CARE LLC
Entity Type:Organization
Organization Name:RESURRECTION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:V
Authorized Official - Last Name:ESTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-451-4971
Mailing Address - Street 1:6007 N SHERIDAN RD APT 15K
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3063
Mailing Address - Country:US
Mailing Address - Phone:312-451-4971
Mailing Address - Fax:
Practice Address - Street 1:5000 W 95TH ST STE B1
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2402
Practice Address - Country:US
Practice Address - Phone:773-656-9848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty