LATRECE RUSSELL

Technician, Other

Active Individual
NPI: 1073936100

Practice Address

4734 S PRAIRIE AVE
Chicago, IL 60615

Phone: (708) 252-1958

Specialties

Specialty Code Primary License
Technician, Other 247200000X Yes -

Frequently Asked Questions

NPI 1073936100 is the National Provider Identifier for LATRECE RUSSELL, a Technician, Other provider located in Chicago, IL. This NPI was enumerated on January 24, 2014.
LATRECE RUSSELL practices at 4734 S PRAIRIE AVE, Chicago, IL 60615.

Quick Facts

NPI
1073936100
Type
Individual
Enumerated
Jan 24, 2014
Last Updated
Jan 24, 2014

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