JOHN RUSSELL

Nurse Practitioner

NPI: 1104237130Individual

Specialties, Licenses & Credentials

Nurse PractitionerPrimary

Nurse Practitioner

Code: 363L00000X

209-011657(IL)277-000310(IL)

Registered Nurse

Registered Nurse

Code: 163W00000X

041.368559(IL)

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Contact & Hours

Address: 1340 CHARLES ST, SUITE 300
ROCKFORD, IL 61104
Phone: (779) 696-8800

Quick Facts

NPI: 1104237130
Entity Type: Individual
Gender: Male
Medicare: Not confirmed
Specialties: 3
Locations: 1

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