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1073834172
KIMBERLY VIRGO RUSSO
CHICAGO, IL
NPI
1073834172
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Former Name
KIMBERLY VIRGO
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2010-06-13
Last Update Date
2016-06-30
Business Address
-- KIMBERLY VIRGO RUSSO DT
2818 S TRIPP AVE
CHICAGO, IL 60623-4336
Phone number: 773-240-5377
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Mailing Address
-- KIMBERLY VIRGO RUSSO DT
7208 W LUNT AVE
CHICAGO, IL 60631-1125
Phone number: 708-717-6594
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