Organization Active NPI

Resurrection Services

  • Family Medicine Physician
  • Westchester, IL
National Provider Identifier
1730296641
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RESURRECTION SERVICES
Practice address
9855 W Roosevelt Rd
Westchester, IL 60154-2758
Phone
(708) 345-3076
Fax
(708) 345-9984
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Len Dedic
Title
Vice President
Phone
(708) 583-6818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9855 W Roosevelt Rd
Westchester, IL 60154-2758

Mailing address

9855 W Roosevelt Rd
Westchester, IL 60154-2758
Phone (708) 345-3076

Other names 1

  • FORREST ROBINSON, DO Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1730296641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9855 W ROOSEVELT RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601542758",
            "telephone_number": "708-345-3076",
            "fax_number": "708-345-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 W ROOSEVELT RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601542758",
            "telephone_number": "708-345-3076",
            "fax_number": "708-345-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURRECTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "DEDIC",
        "authorized_official_first_name": "LEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "708-583-6818"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORREST ROBINSON, DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westchester, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.