Individual
RUSSELL W. NORWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12935 GREGORY ST, BLUE ISLAND, IL 60406-2428
(708) 385-4433
Mailing address
3300 BURR OAK AVE, 2ND FLOOR, BLUE ISLAND, IL 60406-3802
(708) 388-0423
(708) 388-1477
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R11145
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000690225
BCBS
KY
05
—
7100017330
—
KY
01
—
P00928212
RR MEDICARE
KY
Enumeration date
03/09/2006
Last updated
07/27/2011
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