NPIMap

Organization Active NPI

Our Lady of the Resurrection Medical Center

Doing business as Addison Emergency Physicians

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1306845763
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
OUR LADY OF THE RESURRECTION MEDICAL CENTER
Doing business as
Addison Emergency Physicians
Practice address
5645 W Addison St
Chicago, IL 60634-4403
Phone
(773) 774-8000
NPI assigned
Jul 19, 2005
Last updated
Nov 26, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
OUR LADY OF THE RESURRECTION MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Authorized official

Name
Michael S Rosenberg, M.D.
Title
Chairman
Phone
(773) 774-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

5645 W Addison St
Chicago, IL 60634-4403

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

Other names 1

  • Addison Emergency Physicians Doing business as

National Provider Directory

National Provider Directory
Part of
Our Lady Res Med Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1306845763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "773-774-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF THE RESURRECTION MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUR LADY OF THE RESURRECTION MEDICAL CENTER",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "773-774-8000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Addison Emergency Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.