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DR. JOSEPH RUSSO, PT, DPT, ATC

Deactivated

DR. JOSEPH RUSSO, PT, DPT, ATC is a Physical Therapy Assistant healthcare provider located in SOUTH ELGIN, Illinois. NPI 1104215441 is deactivated in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · SOUTH ELGIN, IL

This NPI has been deactivated. The record was deactivated on May 22, 2018. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1104215441
Provider Type
Individual
Gender
Male
NPI Issued
Jan 9, 2015 (3.3643835616438 yrs)
Last Updated
Feb 8, 2024
Deactivated
May 22, 2018
License
070024137 (IL)

Practice Information

Address
486 RANDALL RD
SOUTH ELGIN, IL, 601773353
Browse IL providers · Browse ZIP 60177
Phone
2247836128
Fax
2247837737
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in SOUTH ELGIN, IL

Name Credential NPI
JENNIFER LOUISE FERGUS PT 1699788661
MELBA AVILES PT 1346464203
CHARLOTTE VICENTE-BRANDON PT 1710196605
CHRISTINE STRONG PT 1982992368
MICHAEL MESINA PT 1992066047
AMBER KAYE HOSEY P.T. 1780023358
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.