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Individual

SONYA A RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.N.M., W.H.N.P.

Contact information

Practice address
1300 FRANKLIN AVE, SUITE #270, NORMAL, IL 61761-3592
(309) 454-1074
(309) 454-3554
Mailing address
1300 FRANKLIN AVE, SUITE #270, NORMAL, IL 61761-3592
(309) 664-5245

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
IL

Other

Enumeration date
11/17/2006
Last updated
07/08/2007
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