SearchIllinois235Z00000X

Fawn Russell

NPI 1326538638 · on the registry since 2018

Practice

Address
490 Avenue Of The Cities
East Moline, IL 61244
Phone
(309) 796-1251
Clinicians at this address
2

Additional practice sites

  • 2109 Cedarwood Dr Ste 200, Muscatine, IA

Registry record

Primary taxonomy
235Z00000X
235Z00000X
Also registered as
235Z00000X
Licence states on file
IA, IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-12-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois