Christine Blair Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.021431 Issued in IL

Practice address

321 Hamilton St
Geneva, IL 60134-2148

Phone

(630) 686-2282

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Christine Blair Dooley Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kenneth Young CenterGroup PAC ID 7416940655, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Kenneth Young Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elk Grove Village, IL
  • NPI 1629083241
  Medicare reassignment Care Compare group NPD
• Action Consulting and Therapy, PLLC

  • Clinical Social Worker
  • Geneva, IL
  • NPI 1730575184
  NPD

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1740839539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 STATE ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741753",
            "telephone_number": "682-560-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 HAMILTON ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342148",
            "telephone_number": "630-686-2282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Grandstand Pl",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601236603",
            "country_code": "US",
            "telephone_number": "847-695-0484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTINE",
        "middle_name": "BLAIR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "DOOLEY",
            "middle_name": "BLAIR",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Joseph Rudolph, MD
• Anne Marie Ruggeri, M.S., CCC/SLP
• Heidi Ruiz-Romero
• Demetra Vlagos Rupp, M.D.
• Hannah Russe
• Victoria Russell, CRNA
• David Joseph Ryan, M.D.
• Gail Lee Ryan, RN MS CRC LCPC
• Melissa Autumn Ryan, CST,CFA,RSA
• Sacrey & Sacrey Dentistry LTD

• Clinical Social Worker in Geneva, IL
• Providers in Geneva, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.