Whalio Doctors

NPI 1992206577

Timothy Morgan Russo, CPO

Practitioner Prosthetist Oak Park, IL

Practice location

Address
401 Harrison St, Oak Park, IL 60304-1427
Phone
(708) 383-2257
Fax
(708) 383-0739
Mailing address
1s376 Summit Ave CT. E, Oakbrook Terrace, IL 60181-3985

Registered specialties (2)

Prosthetist Primary
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence 211.000298 (IL)
Orthotist
Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X Licence 213.000337 (IL)

Registry record

NPI
1992206577
Entity type
Individual
Sex (as registered)
Male
NPI issued
28 Feb 2018
Record last updated
28 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.