RESURRECTION HEALTH CARE (NPI# 1518239706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518239706 |
| Entity Type | Organization |
| Organization Name | RESURRECTION HEALTH CARE |
| Other Organization Name | RESURRECTION BEHAVIORAL HEALTH |
| Practice Address |
1414 Main St Melrose Park IL 60160-3902 |
| Practice Telephone | 7088810073 |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2012-02-02 |
| Authorized Official Name | MR. JOHN MYRON NETHERLY (BEHAVIORAL HEALTH TECHNICAM) |
| Authorized Official Telephone | 7735675110 |
| Authorized Official Credential | MSW, MA, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 261QM0801X | IL | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Resurrection Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003121658 | Resurrection Health Care | Student in an Organized Health Care Education/Training Program | 2617 W Iowa St, Chicago, IL 60622-4577 | 2010-08-06 |
| 1275660623 | Resurrection Health Care | Case Management | 9845 W Roosevelt Rd, Westchester, IL 60154-2758 | 2007-02-27 |
| 1013285220 | Resurrection Health Care | Clinic/Center | 1414 Main, Melrose Park, IL 60160 | 2011-12-02 |
| 1245507573 | Resurrection Health Care | Clinic/Center | 1414 Main St, Melrose Park, IL 60160-3902 | 2011-12-01 |
| 1548542673 | Resurrection Health Care | Rehabilitation Hospital | 1431 N Claremont Ave, 2nd Floor Pavillion, Chicago, IL 60622-1702 | 2011-09-14 |
| 1124307806 | Resurrection Health Care | General Acute Care Hospital | 5645 W Addison St, Chicago, IL 60634-4403 | 2011-08-11 |
| 1285943530 | Resurrection Health Care | Psychiatric Unit | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2010-10-05 |
| 1073718748 | Resurrection Health Care | Clinic/Center | 1111 Superior St, #207, Melrose Park, IL 60160-4138 | 2007-06-20 |
| Street Address |
1414 MAIN ST |
| City | MELROSE PARK |
| State | IL |
| Zip Code | 60160-3902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750997193 | Anjali Dinesh Nair | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-21 |
| 1821603671 | Kehinde O Oyinloye | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-09 |
| 1093320814 | Shaquita Ramey | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-09 |
| 1821602723 | Yenisis Delossantos | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-09-08 |
| 1548871379 | Evelyn Darlene Simmons | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-08-14 |
| 1730707050 | Dianne E Lozano | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-07-13 |
| 1346867744 | Luz Luna | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-07-01 |
| 1396362166 | Felix Gatica | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-06-28 |
| 1992320485 | Mayra Diaz | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-06-10 |
| 1982243283 | Asmat Khan | Counselor | 1414 Main St, Melrose Park, IL 60160-3902 | 2020-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295217651 | Kairsten Thies | Registered Nurse | 1225 W. Lake St., Melrose Park, IL 60160 | 2018-09-02 |
| 1780195701 | Julia Mccann-khludenev | Nurse Practitioner | 153 1/2 Broadway Ave., Melrose Park, IL 60160 | 2017-10-17 |
| 1629595749 | Katarzyna Teresa Buksa | Speech-Language Pathologist | 906 Walton St., Melrose Park, IL 60160 | 2017-08-29 |
| 1972955102 | Erika Lazaro | Counselor | 1414 Main Street, Melrose Park, IL 60160 | 2016-07-12 |
| 1811344096 | Margaret Ann Kress | Nurse Practitioner | 675 W North Ave Ste 402, Melrose Park, IL 60160 | 2016-05-18 |
| 1942578703 | Rachna Shah Md Sc | Internal Medicine | 675 West North Ave, #310, Melrose Park, IL 60160 | 2011-12-08 |
| 1033486741 | Stephanie Lamonica | Pharmacist | 850 West North Ave, T0837, Melrose Park, IL 60160 | 2011-11-23 |
| 1285913384 | Melinda Vazquez | Social Worker | 1414 Main, Melrose Park, IL 60160 | 2011-08-08 |
| 1629373212 | Advanced Wellness Clinics | Internal Medicine | 1835 N Broadway Avenue, Suite 104, Melrose Park, IL 60160 | 2011-01-13 |
| 1508188525 | Guillermo Fernando Mora | Family Medicine | 1111 W Superior, Suite #306, Melrose Park, IL 60160 | 2010-02-17 |
| Find all providers in zip 60160 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447520739 | Resurrection Healthcare | Community Based Residential Treatment Facility, Mental Illness | 1414 Main St, Melrose Park, IL 60160-3902 | 2012-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245851690 | Brown Health Care Solutions LLC | Community Based Residential Treatment Facility, Mental Illness | 7330 S Blackstone Ave, Chicago, IL 60619-2150 | 2020-04-27 |
| 1376187617 | Haven Pointe L3c | Community Based Residential Treatment Facility, Mental Illness | 4056 W 115th St Apt 100, Chicago, IL 60655-4333 | 2019-10-30 |
| 1386285682 | Monte Nido Illinois, LLC | Community Based Residential Treatment Facility, Mental Illness | 28w510 Washington Ave, Winfield, IL 60190-1537 | 2019-10-08 |
| 1285281188 | Demetrious Walker | Community Based Residential Treatment Facility, Mental Illness | 2430 Athens Rd, Olympia Fields, IL 60461-1954 | 2019-08-25 |
| 1093209264 | Lester & Rosalie Anixter Center | Community Based Residential Treatment Facility, Mental Illness | 5108 W Roscoe St, Chicago, IL 60641-4204 | 2018-06-20 |
| 1689124877 | Cornerstone Suppport Cila Home | Community Based Residential Treatment Facility, Mental Illness | 125 E 144th Ct, Harvey, IL 60426-1218 | 2016-10-11 |
| 1124575733 | Robert Young Center | Community Based Residential Treatment Facility, Mental Illness | 2701 - 17 Street, Rockisland, IL 61201 | 2016-09-01 |
| 1578910063 | Stepping Stones of Rockford, Inc | Community Based Residential Treatment Facility, Mental Illness | 3319 Darwood Dr, Rockford, IL 61101-2727 | 2016-05-16 |
| 1588018162 | Stepping Stones of Rockford, Inc | Community Based Residential Treatment Facility, Mental Illness | 3729 N Main St, Rockford, IL 61103-1611 | 2016-04-20 |
| 1194194175 | Compassion Cila Homes Inc | Community Based Residential Treatment Facility, Mental Illness | 304 Springfield St, Park Forest, IL 60466-1145 | 2015-09-18 |
| Find all providers with the same taxonomy | ||||
| City | MELROSE PARK |
| Zip Code | 60160 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.