MRS. ELISSA RUSSELL (NPI# 1225316722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225316722 |
| Entity Type | Individual |
| Full Name | MRS. ELISSA RUSSELL |
| Credential | APN, CNP |
| Practice Address |
1340 Charles St Suite 300 Rockford IL 61104 |
| Mailing Address |
Po Box 78866 Milwaukee WI 53278-8866 |
| Practice Telephone | 7796965888 |
| Mailing Telephone | 7796967150 |
| Mailing Fax Number | 7796967342 |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2018-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 209008946 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209008946 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265738470 | Elissa S Russell | Counselor | 618 Pickens Rd, Yakima, WA 98908-1841 | 2011-02-04 |
| Street Address |
1340 CHARLES ST SUITE 300 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418143 | Kathleen Edna Williams | Nurse Practitioner | 1340 Charles St, Ste 201, Rockford, IL 61104 | 2005-06-23 |
| 1124526652 | Drew W Pearson | Registered Nurse | 1340 Charles St, Rockford, IL 61104-2200 | 2018-01-30 |
| 1417483322 | Andrea K Mehlbaum | Registered Nurse | 1340 Charles St, Suite 200, Rockford, IL 61104-2200 | 2017-05-11 |
| 1770030801 | Mary L Marshall | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104-2200 | 2016-09-07 |
| 1518318047 | Laura G Padron | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2016-06-27 |
| 1689056285 | Mary E Novotny | Registered Nurse | 1340 Charles St, Suite 100, Rockford, IL 61104 | 2015-06-19 |
| 1356759294 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2014-07-23 |
| 1104237130 | John Russell | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2014-05-13 |
| 1760824114 | Kaitlin L Georgiafandis | Physician Assistant | 1340 Charles St, Rockford, IL 61104-2200 | 2013-07-26 |
| 1326486895 | Daniel Clark Painter | Physical Medicine & Rehabilitation | 1340 Charles St, Suite 100, Rockford, IL 61104-2200 | 2013-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138481 | Kelly Ann Twigg | Nurse Practitioner | 5669 Shelley Rd, Rockford, OH 45882-9577 | 2020-09-14 |
| 1699389882 | Mary Ann Shaw | Nurse Practitioner | 207 W Main Ave, Rockford, IA 50468-1213 | 2020-09-04 |
| 1124632922 | Catherine Nwosu | Nurse Practitioner | 3455 Holiday Dr Apt 10, Rockford, IL 61109-2489 | 2020-08-31 |
| 1790314631 | Toni A Hughart | Nurse Practitioner | 6000 E State St, Rockford, IL 61108-2521 | 2020-04-03 |
| 1578199220 | Keli S Griseta | Nurse Practitioner | 3505 N Bell School Rd, Rockford, IL 61114-6624 | 2020-03-13 |
| 1457986069 | Nicole P Falatic | Nurse Practitioner | 153 Glen Eagle Dr Ne, Rockford, MI 49341-1183 | 2020-03-04 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1487110540 | Karrie Hagger | Nurse Practitioner | 7476 Countryshire Ln, Rockford, IL 61107-2774 | 2019-02-13 |
| 1336652700 | Stacey Jo Caler | Nurse Practitioner | 363 Financial Ct Unit 300, Rockford, IL 61107-6671 | 2017-11-08 |
| Find all providers in ROCKFORD | ||||
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| 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.