Timothy J. Russell D.O.

NPI 1962418103 - Emergency Medicine - 207P00000X

NPI Details
NPI 1962418103
Gender Male
Enumeration Date 07/31/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1200 MAPLE RD
SILVER CROSS
JOLIET IL, 60432-1439, US
Phone (815) 741-1100
Fax
Business Location
11627 WALNUT CT
BURR RIDGE IL, 60527-8037, US
Phone
Fax
Toxanomy
Taxonomy Code 207P00000X
License State Illinois
License Number 036-0685741
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According to our database, Timothy J. Russell D.O. NPI is 1962418103, taxonomy code is 207P00000X and license number is 036-0685741, license state is located at Illinois. Timothy J. Russell D.O. physically located at 1200 Maple Rd, Joliet IL, 60432-1439. NPI Number Timothy J. Russell D.O. has the Individual type.

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1962418103 NPI number is provided on an as is basis without warranty of any kind. 1962418103 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy J. Russell D.O. are for informational purposes only.