NPI | 1790078053 |
---|---|
Former Legal Business Name | RESURRECTION SERVICES |
Entity Type | Organization |
Authorized Contact | MELVONNE WICKLIFFE-JONES Credentialing Mgr 630-914-2417 |
Organization Subpart ? | No |
Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IL 036043445) |
207RA0201X Internal Medicine, Allergy & Immunology (Licence: IL 036043445) | |
Enumeration Date | 2011-05-19 |
Last Update Date | 2013-04-10 |