Individual
CARA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
303 LANDMARK DR STE 2B, NORMAL, IL 61761-6164
(303) 808-2388
(309) 808-2668
Mailing address
116 1/2 W LOCUST ST APT 3, FAIRBURY, IL 61739-1575
(309) 262-6777
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043-081235
IL
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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