Active NPI
Resurrection Services
- Family Medicine Physician
- Westchester, IL
National Provider Identifier
1730296641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
National Provider Directory
National Provider DirectoryNPI 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.