Russell, Lisa M

Russell, Lisa M is an individual health care provider with primary practice located at 1501 S California Ave , Chicago IL 60608-1732. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is her primary health care specialty. Russell, Lisa M can be contacted via phone (773) 257-6468.

Contact Information

Primary practice address
1501 S California Ave Chicago IL 60608-1732
Phone: (773) 257-6468
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X Illinois
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X Illinois

Profile Details

NPI number 1265420210
LBN Legal business name Russell, Lisa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Jul 13th, 2026 - about 3 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1265420210 NPPES
Illinois MEDICAID 036-095012-2

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