Elleven, Russell

Elleven, Russell is an sole proprietor health care provider with primary practice located at 201 S Stewart Ave , Libertyville IL 60048-2743. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Elleven, Russell can be contacted via phone (312) 330-5353.

Contact Information

Primary practice address
201 S Stewart Ave Libertyville IL 60048-2743
Phone: (312) 330-5353
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 36465 Illinois

Profile Details

NPI number 1831783109
LBN Legal business name Elleven, Russell
Credentials DMIN, EDD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2021
Last updated Feb 26th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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