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Individual

MS. LISA R RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3999 WHISPERING TRAILS CT, HOFFMAN ESTATES, IL 60192-1547
(847) 874-7600
Mailing address
3999 WHISPERING TRAILS CT, HOFFMAN ESTATES, IL 60192-1547

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.005792
IL

Other

Enumeration date
07/21/2010
Last updated
07/21/2010
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