NPIMap

Organization Active NPI

Resurrection Services

Doing business as Max Pitlosh, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1811004708
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RESURRECTION SERVICES
Doing business as
Max Pitlosh, MD
Practice address
2310 W Touhy Avenue
Chicago, IL 60645
Phone
(773) 764-9527
Fax
(773) 764-9539
NPI assigned
Aug 24, 2006
Last updated
Oct 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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 Physician 207Q00000X NU Primary

Addresses

Primary practice location

2310 W Touhy Avenue
Chicago, IL 60645

Mailing address

2310 W Touhy Avenue
Chicago, IL 60645
Phone (773) 764-9527

Other identifiers 1

IdentifierTypeStateIssuer
214325OtherMEDICARE GROUP

Other names 1

  • MAX PITLOSH, 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1811004708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 W TOUHY AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60645",
            "telephone_number": "773-764-9527",
            "fax_number": "773-764-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 W TOUHY AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60645",
            "telephone_number": "773-764-9527",
            "fax_number": "773-764-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURRECTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-10-26",
        "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": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "214325",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAX PITLOSH, 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.
  • 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.