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1043241839
MARY KRYSTOFIAK RUSSELL
CHICAGO, IL
NPI
1043241839
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: IL 164.004471)
Enumeration Date
2006-07-06
Last Update Date
2007-07-08
Business Address
-- MARY KRYSTOFIAK RUSSELL RD
5841 S MARYLAND AVE MC 0988
CHICAGO, IL 60637-1447
Phone number: 773-770-2150
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Mailing Address
-- MARY KRYSTOFIAK RUSSELL RD
5841 S MARYLAND AVE MC 0988
CHICAGO, IL 60637-1447
Phone number: 773-770-2150
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