Individual
DR. SUSAN RENEE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
675 N SAINT CLAIR ST, SUITE 18-250, CHICAGO, IL 60611-5975
(312) 695-1800
(312) 695-4741
Mailing address
675 N SAINT CLAIR ST, SUITE 18-250, CHICAGO, IL 60611-5975
(312) 695-1800
(312) 695-4741
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.117380
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036.117380
IL
207RP1001X
Pulmonary Disease Physician
Primary
036.117380
IL
Other
Enumeration date
08/08/2008
Last updated
08/27/2012
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