Individual
CATHERINE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
755 W BUENA AVE, APT 307, CHICAGO, IL 60613-2272
(518) 588-0455
Mailing address
755 W BUENA AVE, APT 307, CHICAGO, IL 60613-2272
(518) 588-0455
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006549
IL
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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