NPIMap

Organization Active NPI

Resurrection Services

  • Family Medicine Physician
  • Mount Prospect, IL
National Provider Identifier
1730478454
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036056559 Issued in IL
Legal business name
RESURRECTION SERVICES
Doing business as
Virendra Patel, MD
Practice address
770 E Northwest Hwy
Mount Prospect, IL 60056-3464
Phone
(847) 454-1001
Fax
(847) 454-1002
NPI assigned
Apr 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Authorized official

Name
Daniel McCormick, FACHE
Title
Sr VP
Phone
(708) 583-6817

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036056559 IL Primary

Addresses

Primary practice location

770 E Northwest Hwy
Mount Prospect, IL 60056-3464

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
036056559MedicaidIL

Other names 1

  • Virendra Patel, MD 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

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1730478454",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 E NORTHWEST HWY",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563464",
            "telephone_number": "847-454-1001",
            "fax_number": "847-454-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURRECTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "708-583-6817",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036056559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056559",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virendra Patel, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.