MR. RONALD C RUSSO (NPI# 1447380985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447380985 |
| Entity Type | Individual |
| Full Name | MR. RONALD C RUSSO |
| Credential | MD |
| Practice Address |
2504 Galen Drive Suite 107 Champaign IL 61821-7048 |
| Practice Telephone | 2173984856 |
| Practice Fax Number | 2173735214 |
| Mailing Telephone | 2173984856 |
| Mailing Fax Number | 2173735214 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225561509 | Ronald Charles Russo Jr. | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2017-04-04 |
| 1497834469 | Ronald Charles Russo | Dentist | 7500 E Mcdonald Dr, Suite 101-b, Scottsdale, AZ 85250-6052 | 2006-11-02 |
| Street Address |
2504 GALEN DRIVE SUITE 107 |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-7048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750892923 | Alban Ingram Miller Jr. | Surgery | 1708 Foxborough Ct, Champaign, IL 61822-8503 | 2017-10-16 |
| 1043241425 | Donna L Decamara | Surgery | 1702 S Mattis Ave, Champaign, IL 61821-5469 | 2006-07-05 |
| 1710148739 | Victor Earl Stams | Surgery | 3105 Fields South Dr, Champaign, IL 61822-3743 | 2008-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1578068524 | Jw Operatory | Surgery | 1811 Saint Johns Ave Ste 100, Highland Park, IL 60035-5607 | 2018-03-29 |
| 1780198796 | Lin Plastic and Reconstructive Surgery Inc | Surgery | 730 W Couch Pl Unit 1409, Chicago, IL 60661-1383 | 2017-11-29 |
| 1972905545 | Jennifer Hein | Surgery | 2631 Williamsburg Ave Ste 102, Geneva, IL 60134-1108 | 2014-09-25 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1043559842 | Msa Alliance, LLC | Surgery | 1 Broadway Plz, Sparta, IL 62286-1800 | 2013-02-14 |
| 1518223791 | Hansel M Debartolo Jr Md Sc | Surgery | 11 Debartolo Dr., Sugar Grove, IL 60554 | 2012-04-02 |
| 1952692717 | Georgios Kokosis | Surgery | 1725 W Harrison St Ste 425, Chicago, IL 60612-3893 | 2011-04-28 |
| 1740596808 | Swedishamerican Hospital | Surgery | 6533 Lexus Dr, Rockford, IL 61108 | 2010-08-27 |
| 1497910905 | Carlos Mario Rivera Serrano | Surgery | 1400 Financial Park, Carbondale, IL 62902-7537 | 2008-07-23 |
| Find all providers with the same taxonomy | ||||
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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.