NPIMap

Organization Active NPI

Resurrection Services

Doing business as The Center for Cancer Care

  • Hematology & Oncology Physician
  • Chicago, IL
National Provider Identifier
1356647960
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036120969 Issued in IL
Legal business name
RESURRECTION SERVICES
Doing business as
The Center for Cancer Care
Practice address
2900 N Lake Shore Dr
7 East
Chicago, IL 60657-5640
Phone
(773) 661-5800
NPI assigned
Jan 28, 2011
Last updated
Jan 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Authorized official

Name
Daniel McCormick
Title
Sr Vice President
Phone
(708) 583-6817

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036120969 IL Primary
Medical Oncology Physician 207RX0202X 036058899 IL

Addresses

Primary practice location

2900 N Lake Shore Dr
7 East
Chicago, IL 60657-5640

Mailing address

PO Box 564437
Chicago, IL 60656-4437
Phone (708) 583-7310

Other identifiers 3

IdentifierTypeStateIssuer
036120969MedicaidIL
036058899MedicaidIL
041243519MedicaidIL

Other names 1

  • THE CENTER FOR CANCER CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050215000965 IL Part B Supplier - Clinic/Group Practice 2860396769 Receives reassigned benefits from 128 practitioners
47 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 46

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 46

National Provider Directory

National Provider Directory

Locations

2900 N Lake Shore Dr
#7E
Chicago, IL 60657
Phone (773) 661-5800

62311 Collection Ctr Dr
Chicago, IL 60696

Practitioners & affiliated clinicians

Practitioners 1

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": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1356647960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 564437",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564437",
            "telephone_number": "708-583-7310",
            "fax_number": "708-583-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "address_2": "7 EAST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-661-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURRECTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "708-583-6817"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036120969",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036058899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120969",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058899",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041243519",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE CENTER FOR CANCER CARE",
            "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 Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.