Presence Resurrection Medical Center | |
7447 W Talcott Suite 182 Chicago IL 60631-0000 | |
(773) 792-5155 | |
(630) 914-2499 |
Full Name | Presence Resurrection Medical Center |
---|---|
Speciality | Family Medicine |
Location | 7447 W Talcott, Chicago, Illinois |
Authorized Official Name and Position | Melvonne Wickliffe-jones (CREDENTIALING MGR) |
Authorized Official Contact | 6309142417 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Presence Resurrection Medical Center 1000 Remington Boulevard Suite 100 Bolingbrook IL 60440-0000 Ph: (630) 914-2417 | Presence Resurrection Medical Center 7447 W Talcott Suite 182 Chicago IL 60631-0000 Ph: (773) 792-5155 |
NPI Number | 1124189139 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 04/10/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124189139 | NPI | - | NPPES |
01615536 | Other | BLUE SHIELD PROVIDER # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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