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1952094880
MICHAEL J RUSSELL
PARK RIDGE, IL
NPI
1952094880
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 178019110)
Enumeration Date
2023-05-26
Last Update Date
2023-06-22
Business Address
Mr. MICHAEL J RUSSELL LPC
250 S NW HIGHWAY SUITE 110
PARK RIDGE, IL 60068
Phone number: 888-428-7890
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Mailing Address
Mr. MICHAEL J RUSSELL LPC
6470 N OLYMPIA AVE
CHICAGO, IL 60631-1519
Phone number: 773-682-9633
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