Individual
RUSSEL LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1611 W HARRISON ST, CHICAGO, IL 60612-4861
(312) 237-1248
Mailing address
14226 S 84TH AVE, ORLAND PARK, IL 60462-2318
(708) 590-6387
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002107
IL
Other
Enumeration date
02/25/2007
Last updated
10/15/2015
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