Individual
MS. AKISHA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9131 S NORMAL AVE, CHICAGO, IL 60620-2316
(773) 651-6168
Mailing address
9131 S NORMAL AVE, CHICAGO, IL 60620-2316
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178007097
IL
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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