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Individual

DR. KEVIN J RUSSEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC, DIBCN, DABFP

Contact information

Practice address
311 S NAPERVILLE RD, SUITE C, WHEATON, IL 60187-5473
(630) 690-4040
Mailing address
311 S NAPERVILLE RD, SUITE C, WHEATON, IL 60187-5473
(630) 690-4040

Taxonomy

Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
038-007072
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022-22298
BC/BS
IL
01
4655917
AETNA
01
79863
HEALTH PARTNERS
01
8228039001
CIGNA
Enumeration date
07/28/2006
Last updated
10/10/2012
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