Individual
MRS. ANGELLIQUE PERRY-RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6425 JOLIET RD APT 1WF, LA GRANGE HIGHLANDS, IL 60525-4293
(708) 288-8445
Mailing address
6425 JOLIET RD APT 1WF, LA GRANGE HIGHLANDS, IL 60525-4293
(708) 288-8445
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/19/2017
Last updated
12/14/2020
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