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1962418103
TIMOTHY J. RUSSELL
TINLEY PARK, IL
NPI
1962418103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: IL 036-0685741)
Enumeration Date
2006-07-31
Last Update Date
2022-06-15
Business Address
TIMOTHY J. RUSSELL D.O.
17495 LA GRANGE RD
TINLEY PARK, IL 60487-7581
Phone number: 708-406-3243
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Mailing Address
TIMOTHY J. RUSSELL D.O.
1860 PAYSPHERE CIR
CHICAGO, IL 60674-0018
Phone number: 630-469-9200
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