Individual
MARY KRYSTOFIAK RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5841 S MARYLAND AVE, MC 0988, CHICAGO, IL 60637-1447
(773) 770-2150
(773) 834-1011
Mailing address
5841 S MARYLAND AVE, MC 0988, CHICAGO, IL 60637-1447
(773) 770-2150
(773) 834-1011
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
07/06/2006
Last updated
07/08/2007
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