Individual
ELIZABETH MARIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,CLT-LANA
Contact information
Practice address
143 BERNICE DR, 143 BERNICE DRIVE, BENSENVILLE, IL 60106-3366
(630) 350-2736
(630) 350-2842
Mailing address
1101 CIRCLE AVE, 1101 CIRCLE AVENUE, FOREST PARK, IL 60130-2326
(708) 488-0520
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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