NPIMap

Organization Active NPI

Resurrection Health Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Melrose Park, IL
National Provider Identifier
1013285220
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
RESURRECTION HEALTH CARE
Doing business as
Resurrection Behavioral Health
Practice address
1414 Main
Melrose Park, IL 60160
Phone
(708) 681-0073
NPI assigned
Dec 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John Myron Netherly Jr., MSW,MA
Title
Behavioral Health Technican
Phone
(773) 759-5110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X IL Primary

Addresses

Primary practice location

1414 Main
Melrose Park, IL 60160

Mailing address

1414 Main St
Melrose Park, IL 60160-3902

Other names 1

  • Resurrection Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Resurrection Behavioral Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1013285220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 MAIN ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MAIN",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "60160",
            "telephone_number": "708-681-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURRECTION HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "NETHERLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MYRON",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH TECHNICAN",
        "authorized_official_telephone_number": "773-759-5110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MSW,MA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resurrection Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.