DERICK M RUSSELL (NPI# 1710907480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710907480 |
| Entity Type | Individual |
| Full Name | DERICK M RUSSELL |
| Credential | MPT |
| Practice Address |
6326 West Roosevelt Rd Oak Park IL 60304 |
| Mailing Address |
1101 Circle Ave Forest Park IL 60130-2326 |
| Practice Telephone | 7086913562 |
| Practice Fax Number | 7086609356 |
| Mailing Telephone | 7086913562 |
| Mailing Fax Number | 7086609356 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
6326 WEST ROOSEVELT RD |
| City | OAK PARK |
| State | IL |
| Zip Code | 60304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689288532 | Kane Physiotherapy, LLC | Physical Therapist | 617 S. Harvey Ave., Oak Park, IL 60304 | 2020-09-08 |
| 1982221909 | Rachel Hunter | Marriage & Family Therapist | 283 Fillmore Street, Oak Park, IL 60304 | 2020-06-26 |
| 1073086211 | Miguel N Reyes Jr. | Behavioral Analyst | 6930 Roosevelt Rd., Oak Park, IL 60304 | 2019-01-10 |
| 1144722687 | Jesus Torres | Behavior Technician | 6930 W Roosevelt Rd, Oak Park, IL 60304 | 2018-03-01 |
| 1184143190 | Ruth Sharel Babcock | Social Worker | 927 S. Kenilworth Ave., Oak Park, IL 60304 | 2017-09-12 |
| 1053832774 | Anna M Bonick | Doula | 528 S. Taylor Ave., Oak Park, IL 60304 | 2017-07-03 |
| 1982968806 | Monica Singhvi | Family Medicine | 610 S Maple Ave Ste 4600, Oak Park, IL 60304 | 2012-06-25 |
| 1588954135 | Rachana Parag Shah | Physical Medicine & Rehabilitation | 610 S. Maple #3420, Oak Park, IL 60304 | 2011-04-17 |
| 1972825818 | Meghan Mcintyre | Counselor | 610 South Maple Avenue, Suite 3400, Oak Park, IL 60304 | 2010-02-19 |
| 1992953954 | Beverly Harrison Dale | Speech-Language Pathologist | 520 S. Maple Ave, Roph, Oak Park, IL 60304 | 2008-09-03 |
| Find all providers in zip 60304 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992297048 | Kenneth White | Physical Therapist | 25900 Greenfield Rd, Oak Park, MI 48237-1292 | 2018-06-05 |
| 1275775421 | Functional Health and Wellness | Physical Therapist | 852 Madison St, Oak Park, IL 60302-4441 | 2009-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986891 | Murtaza Aziz | Physical Therapist | 1431 N Western Ave Ste 140, Chicago, IL 60622-1770 | 2020-09-14 |
| 1902416720 | Epicore Physical Therapy | Physical Therapist | 1660 N La Salle Dr Apt 2708, Chicago, IL 60614-6021 | 2020-08-06 |
| 1356968374 | Genevieve Joy Owen | Physical Therapist | 555 Busse Hwy Unit C1, Park Ridge, IL 60068-3189 | 2020-06-26 |
| 1518597772 | Stability Physical Therapy and Wellness, LLC | Physical Therapist | 5031 W Balmoral Ave, Chicago, IL 60630-1507 | 2020-01-16 |
| 1154972719 | Antonio Marquez | Physical Therapist | 7425 Janes Ave Ste 200, Woodridge, IL 60517-2358 | 2019-09-25 |
| 1376198978 | Natalie N Ruebke | Physical Therapist | 251 Marketplace Dr # 2, Freeburg, IL 62243-4082 | 2019-08-09 |
| 1902360241 | Stephanie Lynne Burkhart | Physical Therapist | 12251 W 159th St, Homer Glen, IL 60491-7847 | 2019-01-30 |
| 1003388943 | Scoliosis Therapy Care and More LLC | Physical Therapist | 4n369 Booth Tarkington St, St Charles, IL 60175-7731 | 2018-12-17 |
| 1912478082 | Brandon Donnelly | Physical Therapist | 2200 Fort Jesse Rd Ste 230, Normal, IL 61761-6291 | 2018-12-16 |
| 1497251086 | John William Herbert | Physical Therapist | 1316 N Route 59, Naperville, IL 60563-4286 | 2018-04-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DERICK M RUSSELL.
| 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.