DR. MARK RUSSELL


Address: 2160 S 1st Ave, Maywood, IL 60153-3328
Phone: 7082169000

DR. MARK RUSSELL (NPI# 1154827756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154827756
Entity Type Individual
Full Name DR. MARK RUSSELL
Credential MD
Practice Address 2160 S 1st Ave
Maywood
IL 60153-3328
Mailing Address 2155 Dogwood Dr Apt 263
Lisle
IL 60532-1789
Practice Telephone 7082169000
Mailing Telephone 6304898877
Enumeration Date 2018-04-03
Last Update Date 2018-04-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Providers MARK RUSSELL

NPI Name Taxonomy Address Enumeration
1831710771 Mark William Russell Dentist 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 2020-05-01
1144752221 Mark Russell Social Worker 475 Sykesville Troutville Rd, Punxsutawney, PA 15767-4367 2017-03-29
1154767267 Mark Stephen Russell Jr. Counselor 3901 Airport Fwy Ste 107, Bedford, TX 76021-6117 2013-05-15
1437314366 Mark William Russell Community Health Worker 108 Schooner Landing Dr, Edenton, NC 27932-8833 2008-07-21
1306867049 Mark Duane Russell Specialist/Technologist 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 2006-07-21
1639137540 Mark Russell Internal Medicine 13024 Hesperia Rd Ste 103, Victorville, CA 92395-8303 2006-05-02
1689671315 Mark Dale Russell Chiropractor 5309 44th St, Lubbock, TX 79414-1321 2005-07-07
1033654967 Mark Russell Pharmacist 2920 Knoxville Center Dr, Knoxville, TN 37924-2013 2017-01-02
1477097392 Mark Russell Social Worker 302 S Spring St, Tupelo, MS 38804-4853 2016-12-12
1134463870 Mark Joseph Russell Occupational Therapist 275 East Main Street, Frankfort, KY 40621-0001 2012-11-19

Office Location

Street Address 2160 S 1ST AVE
City MAYWOOD
State IL
Zip Code 60153-3328

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174525489 Michael Jm Raffin Audiologist 2160 S 1st Ave, Maywood, IL 60153-3328 2005-06-01
1366049900 Kenneth Bernard Jordan Psychiatry & Neurology 2160 S 1st Ave, Maywood, IL 60153-3328 2020-10-06
1124634712 Abhilasha Nitin Borkar Pathology 2160 S 1st Ave, Maywood, IL 60153 2020-09-18
1306450325 Linda Ippolito Nurse Practitioner 2160 S 1st Ave, Maywood, IL 60153-3328 2020-09-08
1194339135 Meghan Henry Nurse Practitioner 2160 S 1st Ave, Maywood, IL 60153-3328 2020-09-08
1194339911 Victoria Leah Drozd Student in an Organized Health Care Education/Training Program 2160 S 1st Ave, Maywood, IL 60153-3328 2020-08-31
1396357588 Madison Schaefer Nurse Practitioner 2160 S 1st Ave, Maywood, IL 60153-3328 2020-08-19
1134731375 Otanthia S Williams-brady Nurse Practitioner 2160 S 1st Ave, Maywood, IL 60153-3328 2020-08-19
1205454287 Janet Nickels Audiologist 2160 S 1st Ave, Maywood, IL 60153-3328 2020-07-07
1417574054 Kathryn Clemans Nurse Anesthetist, Certified Registered 2160 S 1st Ave, Maywood, IL 60153-3328 2020-06-30
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053933077 Judie Noemie Hoilat Internal Medicine 2160 S 1st Avenue, Maywood, IL 60153 2020-05-13
1457972457 Yuchen Zheng Student in an Organized Health Care Education/Training Program Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 2020-04-30
1437779519 Amna Amad Siddiqui Student in an Organized Health Care Education/Training Program 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 2020-04-20
1982232211 Brian Kurtz Student in an Organized Health Care Education/Training Program 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 2020-03-31
1902434947 Saadiya Jabbar Psychiatry & Neurology Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 2020-03-27
1558919472 Linda Sue Moton Technician 10 South 15 Apt. 1, Maywood, IL 60153 2019-09-04
1760047518 Braden Robert Dasovic Student in an Organized Health Care Education/Training Program 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 2019-05-07
1134680713 Madeline Shaoyun Tiee Orthopaedic Surgery Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 2019-03-27
1538629746 Michael Murphy Orthopaedic Surgery 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 2019-03-22
1053871681 Michael V Padua Psychiatry & Neurology 2160 S 1st Ave Bldg, Maywood, IL 60153 2019-03-20
Find all providers in zip 60153

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457972457 Yuchen Zheng Student in an Organized Health Care Education/Training Program Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 2020-04-30
1437779519 Amna Amad Siddiqui Student in an Organized Health Care Education/Training Program 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 2020-04-20
1982232211 Brian Kurtz Student in an Organized Health Care Education/Training Program 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 2020-03-31
1013540244 Lisa Laurenzana Student in an Organized Health Care Education/Training Program 2160 S 1st Ave Bldg Stritch, Maywood, IL 60153-3328 2020-02-17
1972149649 Jenna Gartz Student in an Organized Health Care Education/Training Program 2160 S 1st Ave Rm 4500, Maywood, IL 60153-3328 2019-11-18
1760047518 Braden Robert Dasovic Student in an Organized Health Care Education/Training Program 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 2019-05-07
1538626718 Tyana Davis Student in an Organized Health Care Education/Training Program 624 S 21st Ave, Maywood, IL 60153-1476 2019-02-25
1801391438 Giacomo Colver Waller Student in an Organized Health Care Education/Training Program 2160 S 1st Ave Ste 2840, Maywood, IL 60153-3328 2018-03-26
1194339911 Victoria Leah Drozd Student in an Organized Health Care Education/Training Program 2160 S 1st Ave, Maywood, IL 60153-3328 2020-08-31
1467073668 Isabel Anne Pennings Student in an Organized Health Care Education/Training Program 2160 S 1st Ave, Maywood, IL 60153-3328 2020-04-29
Find all providers in MAYWOOD

Competitor

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City MAYWOOD
Zip Code 60153

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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