Russell, Kevin John

Russell, Kevin John is an sole proprietor health care provider with primary practice located at 5435 Bull Valley Rd Ste 106 , Mchenry IL 60050-2209. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Russell, Kevin John can be contacted via phone (815) 382-8378.

Contact Information

Primary practice address
5435 Bull Valley Rd Ste 106 Mchenry IL 60050-2209
Phone: (815) 382-8378
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 180002771 Illinois

Profile Details

NPI number 1366543167
LBN Legal business name Russell, Kevin John
Credentials LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2006
Last updated Sep 20th, 2011 - about 15 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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