Joseph Russell, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036064556 Issued in IL

Practice address

24020 W Riverwalk CT Ste 102
Plainfield, IL 60544-7107

Phone

(815) 676-2528

Fax

(815) 676-2586

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1407824980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24020 W RIVERWALK CT STE 102",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605447107",
            "telephone_number": "815-676-2528",
            "fax_number": "815-676-2586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14710 S Naperville Rd",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IL",
            "postal_code": "605443313",
            "country_code": "US",
            "telephone_number": "815-676-2580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036064556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064556",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrusselldo1545@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "24020 W Riverwalk Ct Ste 102",
            "city": "Plainfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605447107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madalyn Joy Rossen, MS
• Michelle Beason Roush, PA-C
• Veronica Yee Concepcion Rueda, PT, DPT
• Allison R Russell
• Brenna Russell, MSW, LSW
• Kathleen G Russo, MS CCC SLP L
• Ruth Reiter, LCSW, PLLC
• Thomas S Ryan, LCPC
• Meghan Rye, BCBA
• S & M Medical Consultants LLC

• Pediatrics Physician in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.