Individual
JOSEPHINE MARY RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
947 S MANNHEIM RD, WESTCHESTER, IL 60154-2515
(708) 550-7005
Mailing address
947 S MANNHEIM RD, WESTCHESTER, IL 60154-2515
(920) 883-7509
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
03/21/2022
Last updated
09/23/2024
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