Individual
DR. MARC JOSEF CONTE-RUSSIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
25 N. WINFIELD RD., SUITE 419, WINFIELD, IL 60190
(630) 653-0848
(630) 653-0988
Mailing address
25 N. WINFIELD ROAD, SUITE 419, WINFIELD, IL 60190
(630) 653-0848
(630) 653-0988
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125.058327
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036131269
—
IL
01
—
920540
MEDICARE PTAN (GROUP)
IL
01
—
F400149873
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
06/02/2010
Last updated
01/05/2015
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