Russell, Mark

Russell, Mark is an individual health care provider with primary practice located at 2160 S 1St Ave , Maywood IL 60153-3328. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Hematology is his primary health care specialty. Russell, Mark can be contacted via phone (708) 216-9000.

Contact Information

Primary practice address
2160 S 1St Ave Maywood IL 60153-3328
Phone: (708) 216-9000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207ZH0000X 036.159014 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1154827756
LBN Legal business name Russell, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2018
Last updated Jun 2nd, 2022 - about 4 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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