Individual
CAROLYN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 REVERE DR, NORTHBROOK, IL 60062-8001
(773) 490-9521
Mailing address
3201 OLD GLENVIEW RD, WILMETTE, IL 60091-2999
(773) 490-9521
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14516164
IL
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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