| NPI | 1396835641 |
|---|---|
| Doing Business As | ROBERT C RUSSELL M D S C |
| Entity Type | Organization |
| Authorized Contact | ROBERT C RUSSELL Ownerpresiden 217-523-0808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036061657) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2013-03-21 |