Individual
DR. CODY NATHANIEL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1775 DEMPSTER ST # 48, PARK RIDGE, IL 60068-1143
(847) 723-2210
(847) 723-6987
Mailing address
1775 DEMPER STREET #48, PARK RIDGE, IL 60068
(847) 723-2210
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125086836
IL
Other
Enumeration date
05/14/2024
Last updated
07/02/2025
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