Organization
FRANK I RUSSO
Active
Other names
Russo Rehabilitation Medicine LTD
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARRIE LYN CHIARAVALLE (DIRECTOR)
(309) 689-6049
Entity
Organization
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE 218, PEORIA, IL 61614-5098
(309) 693-2244
(309) 693-7606
Mailing address
5401 N KNOXVILLE AVE, SUITE 209, PEORIA, IL 61614-5098
(309) 693-2244
(309) 693-7606
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/27/2006
Last updated
08/22/2020
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