Active NPI
Judith D Russell, RN
- Registered Nurse
- Chicago, IL
National Provider Identifier
1649770827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041.272512
- Practice address
- 4740 N Clark St
Chicago, IL 60640-4689 - Phone
- (773) 769-0205
- NPI assigned
- Feb 14, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.272512 | IL | Primary |
Addresses
Primary practice location
4740 N Clark St
Chicago, IL 60640-4689
Mailing address
1517 Mulford St
Evanston, IL 60202-3231
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.272512 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518566400000",
"number": "1649770827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1517 MULFORD ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602023231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4740 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404689",
"telephone_number": "773-769-0205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "JUDITH",
"middle_name": "D",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-14",
"last_updated": "2018-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.272512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.