Georgeann L Iacono Russell in River Forest - Clinical
Georgeann L Iacono Russell - NPI 1164552154
Georgeann L Iacono Russell is a Clinical in River Forest, Illinois. Georgeann L Iacono Russell practices all healthcare services and medical treatments related to Clinical. The NPI Number for Georgeann L Iacono Russell is 1164552154. The last update date is 2011-03-11.
Georgeann L Iacono Russell's current location address is 7411 West Lake Street, River Forest, Illinois. You can contact this provider via phone number 7084881919 and fax number 7087632120. The mailing address for Georgeann L Iacono Russell is 7411 West Lake Street, River Forest, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Georgeann L Iacono Russell |
|---|---|
| Address | 7411 West Lake Street, River Forest, Illinois |
| Phone Number | 7084881919 |
| Fax Number | 7087632120 |
| Sole Proprietor | N |
| Credentials | PH.D |
NPI Number Detail
| NPI Number | 1164552154 |
|---|---|
| Provider Enumeration Date | 2007-03-07 |
| Last Updated Date | 2011-03-11 |
Provider Mailing Address Detail
| Address | 7411 West Lake Street |
|---|---|
| City | River Forest |
| State | Illinois (IL) |
| Post Code | 603051876 |
| Phone Number | 7084881919 |
| Fax Number | 7087632120 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 071-004593 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 21623162 | IL | BCBS GROUP NUMBER |
Post Comment/ Review Below
What is the unique provider identifier assigned to Georgeann L Iacono Russell?
The Georgeann L Iacono Russell has been issued the NPI (National Provider Identifier) 1164552154 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Georgeann L Iacono Russell?
The Georgeann L Iacono Russell is situated at 7411 West Lake Street, in the city of River Forest, state of IL, with the zip code 603051876.
What is Georgeann L Iacono Russell's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Georgeann L Iacono Russell is Clinical, and the taxonomy code that classifies this field of practice is 103Tc0700X.
When did Georgeann L Iacono Russell receive its 1164552154 assignment?
The Georgeann L Iacono Russell was assigned its 1164552154 on 2007-03-07, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Georgeann L Iacono Russell last refreshed?
The information related to the Georgeann L Iacono Russell, including its address, specialty, and other relevant details, was last updated on 2011-03-11.
NPI Number: 1720081763
Address: 675 E Highway 60, Hardinsburg, KY