Roberto Russo

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160006663 Issued in IL

Practice address

1919 Skokie Valley Rd
Highland Park, IL 60035-2361

Phone

(224) 765-5550

Fax

(224) 765-5551

NPI assigned

Nov 24, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1385251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1417387663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD",
            "address_2": "SUITE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 SKOKIE VALLEY RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352361",
            "telephone_number": "224-765-5550",
            "fax_number": "224-765-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ROBERTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-24",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160006663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Germaine Dabney Rubens, CRNA
• Harley Glenn Rubens, M.D.
• Darcy Rubin, CNP
• Robert E Ruderman, M.D.
• Kelly Ann Runningen, LSW
• Emma E Ryan, MD
• Malgorzata Monika Rybka-O'Malley
• S Pope DDS & R Hurwich DDS P.C.
• Gloria A Sa, APN-CNP
• Karen S Sable, M D

• Physical Therapy Assistant in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; 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.