Individual
MR. RONALD C RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2504 GALEN DRIVE, SUITE 107, CHAMPAIGN, IL 61821-7048
(217) 398-4856
(217) 373-5214
Mailing address
2504 GALEN DRIVE, SUITE 107, CHAMPAIGN, IL 61821-7048
(217) 398-4856
(217) 373-5214
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
IL
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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