Individual
IGOR RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6931 NORTH AVE, OAK PARK, IL 60302-1053
(708) 763-0580
(708) 763-0586
Mailing address
2935 W 63RD ST, CHICAGO, IL 60629-2753
(708) 763-9622
(773) 863-7675
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008831
IL
Other
Enumeration date
08/06/2006
Last updated
08/24/2016
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