Individual
MARGARET RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2750 W NORTH AVE, CHICAGO, IL 60647-5247
(312) 432-2767
Mailing address
2750 W NORTH AVE, CHICAGO, IL 60647-5247
(312) 432-2767
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036149919
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036149919
—
IL
Enumeration date
01/31/2015
Last updated
08/11/2021
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