DR. Jon W Russell, O.D.

NPI #1831177088 in Marengo, Illinois

Provider Information

NPI Number: 1831177088
Entity Type: Individual
Name: DR. Jon W Russell, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Jan 6, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 205 N STATE ST
City: Marengo
State: Illinois
ZIP Code: 60152-2239
Phone: (815) 568-6508

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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Organizations

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