Individual
ELIZABETH ANNE RUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3000 N HALSTED ST STE 320, CHICAGO, IL 60657-5190
(773) 296-3636
Mailing address
1918 FRANKLIN CT, GURNEE, IL 60031-6307
(847) 494-0268
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.017808
IL
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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