Russell, Derick M
Russell, Derick M is an sole proprietor health care provider with primary practice located at 6326 West Roosevelt Rd , Oak Park IL 60304. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Russell, Derick M can be contacted via phone (708) 691-3562.Contact Information
Primary practice address
6326 West Roosevelt Rd
Oak Park IL 60304
Phone: (708) 691-3562
Fax: (708) 660-9356
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | Illinois |
Profile Details
| NPI number | 1710907480 |
|---|---|
| LBN Legal business name | Russell, Derick M |
| Credentials | Master of Physical Therapy (MPT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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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