Individual
MR. CHRISTOPHER MARK RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 EASTLAND DR, BLOOMINGTON, IL 61701-3552
(309) 663-8311
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(309) 663-8311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036168208
IL
Other
Enumeration date
07/08/2021
Last updated
07/24/2024
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