Timothy Morgan Russo, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

211.000298 Issued in IL

Practice address

401 Harrison St
Oak Park, IL 60304-1427

Phone

(708) 383-2257

Fax

(708) 383-0739

NPI assigned

Feb 28, 2018

Last updated

Feb 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1992206577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S376 SUMMIT AVE",
            "address_2": "CT. E",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813985",
            "telephone_number": "630-705-4092",
            "fax_number": "630-424-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HARRISON ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041427",
            "telephone_number": "708-383-2257",
            "fax_number": "708-383-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "TIMOTHY",
        "middle_name": "MORGAN",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "IL",
            "license": "213.000337",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "IL",
            "license": "211.000298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deandranay Russell
• Derick M Russell, MPT
• Frank Russo
• Igor Russo, D.C.
• Maureen Bella Russo, MA, ATR-P
• Nancy Joan Ryan, OTR/L
• Ralph G. Ryan, M.D.
• S and R Drugs Inc / Dba: Sears Pharmacy (Sears Pharmacy)
• S.N. Turner and Associates, LLC
• Sydney Sabbagha

• Prosthetist in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Prosthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.

Verify at the official NPI Registry.