Individual
MRS. SUZANNE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
(708) 326-1550
Mailing address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
(708) 326-1550
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004450
IL
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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