Active NPI
Resurrection Services
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1487735510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- RESURRECTION SERVICES
- Practice address
- 2246 W. Chicago Avenue
Chicago, IL 60622 - Phone
- (773) 276-6831
- Fax
- (773) 276-9394
- NPI assigned
- Oct 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leonard Dedic
- Title
- Vice President
- Phone
- (708) 583-6818
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
2246 W. Chicago Avenue
Chicago, IL 60622
Mailing address
2246 W. Chicago Avenue
Chicago, IL 60622
Phone (773) 276-6831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214696 | Other | MEDICARE GROUP |
Other names 1
- SHANNON KROPP, MD
National Provider Directory
National Provider DirectoryLocations
2246 W Chicago Ave
Chicago, IL 60622
Phone (773) 276-6831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1193356800000",
"number": "1487735510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2246 W. CHICAGO AVENUE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60622",
"telephone_number": "773-276-6831",
"fax_number": "773-276-9394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2246 W. CHICAGO AVENUE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60622",
"telephone_number": "773-276-6831",
"fax_number": "773-276-9394"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RESURRECTION SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-17",
"last_updated": "2007-10-26",
"status": "A",
"authorized_official_last_name": "DEDIC",
"authorized_official_first_name": "LEONARD",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "708-583-6818"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "214696",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SHANNON KROPP, MD",
"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 Oct 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.