Individual
JUDITH D RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
Mailing address
1517 MULFORD ST, EVANSTON, IL 60202-3231
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.272512
IL
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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