HOLLY RUSSELL (NPI# 1174727267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174727267 |
| Entity Type | Individual |
| Full Name | HOLLY RUSSELL |
| Credential | M.D. |
| Practice Address |
18210 La Grange Rd Suite 205 Tinley Park IL 60487-7722 |
| Mailing Address |
1465 S Grand Blvd Rm 1206 Saint Louis MO 63104-1003 |
| Practice Telephone | 7084787800 |
| Practice Fax Number | 7084787870 |
| Mailing Telephone | 3145775694 |
| Mailing Fax Number | 3145775616 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2009-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 036120579 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 2005017735 | MO | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036120579 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942692512 | Holly Russell | Pharmacist | 961 Threewood Cir, Bowling Green, KY 42103-2480 | 2015-02-19 |
| 1285918052 | Holly Russell | Occupational Therapist | 10320 N New Jersey St, Indianapolis, IN 46280-1360 | 2011-09-28 |
| 1548860158 | Holly Russell | Pharmacist | 407 N State St, Desloge, MO 63601-3053 | 2020-11-01 |
| 1083233258 | Holly Russell | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr, Lebanon, OR 97355-3983 | 2020-04-08 |
| 1518442862 | Holly Ann Russell | Dietitian, Registered | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2018-10-02 |
| 1104338623 | Holly L Russell | Nurse Practitioner | 2900 16th St, Bedford, IN 47421-3510 | 2017-10-25 |
| 1215319488 | Holly Russell | Licensed Practical Nurse | 11009 Louis Dr Se, Huntsville, AL 35803-1007 | 2015-06-24 |
| 1689673410 | Holly Roxanne Russell | Physical Therapist | 2907 Williamson County Pkwy, Marion, IL 62959-5256 | 2005-07-14 |
| Street Address |
18210 LA GRANGE RD SUITE 205 |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60487-7722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053319111 | Gene Denning | Pediatrics | 18210 La Grange Rd, Suite 205, Tinley Park, IL 60477-7722 | 2005-07-12 |
| 1407476096 | Kristin Butkus | Nurse Practitioner | 18210 La Grange Rd, Tinley Park, IL 60487-7722 | 2020-04-23 |
| 1245703354 | Shawntell Jackson | Nurse Practitioner | 18210 La Grange Rd, Ste 209, Tinley Park, IL 60487-7728 | 2019-01-10 |
| 1609343763 | Denise Castle | Clinic/Center | 18210 La Grange Rd, Tinley Park, IL 60487-7722 | 2018-10-26 |
| 1538577937 | Connect Hearing, Inc. | Audiologist | 18210 La Grange Rd, Ste. 103, Tinley Park, IL 60487-7722 | 2014-07-29 |
| 1043659071 | Sonia K Virparia | Family Medicine | 18210 La Grange Rd, Suite 200, Tinley Park, IL 60487-7722 | 2013-06-24 |
| 1194071076 | Rachel A Lucas | Physical Therapist | 18210 La Grange Rd, Suite 100, Tinley Park, IL 60487-7722 | 2012-07-30 |
| 1740511328 | Lisa A Daigler | Physical Therapist | 18210 La Grange Rd, Tinley Park, IL 60487-7722 | 2010-01-21 |
| 1801045539 | Tracey Ingram | Audiologist | 18210 La Grange Rd, Ste 103, Tinley Park, IL 60487-7722 | 2008-09-18 |
| 1396916409 | Southtown Allergy and Asthma Care, PC | Clinic/Center | 18210 La Grange Rd, Suite 201, Tinley Park, IL 60487-7722 | 2008-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850492 | Essential Counseling Group LLC | Social Worker | 17550 W Quail Trail, Tinley Park, IL 60487 | 2020-08-04 |
| 1457972705 | Michelle E Estand | Speech-Language Pathologist | 8200 185th, Tinley Park, Il 60487, Suite A/b, Suite A/b, Suite A/b, Tinley Park, IL 60487 | 2020-04-28 |
| 1659839108 | Jasmine Mccloskey | Behavioral Analyst | Cards, 8505 183rd Suite D, IL 60487 | 2019-03-04 |
| 1669951158 | Christine Marie Cavanaugh | Developmental Therapist | 8384 Dunmore Dr, Tinley Park, IL 60487 | 2018-08-07 |
| 1851810998 | Jeffrey Beck | Counselor | 16243 Haven Ave., Orland Hills, IL 60487 | 2017-09-09 |
| 1730634700 | Liyun Huang | Internal Medicine | 17495 South La Grange Rd, Tinley Park, IL 60487 | 2016-08-19 |
| 1780016162 | Kristin Ann Strausbaugh | Nurse Practitioner | 7300 191st Street, Tinley Park, IL 60487 | 2013-08-07 |
| 1679855597 | Florence Delavega | Pharmacist | 9151 Mansfield Dr, Tinley Park, IL 60487 | 2011-09-16 |
| 1912285685 | Michelle Vansetten | Behavioral Analyst | 8200 W. 185th Street, Suite A/b, Tinley Park, IL 60487 | 2011-07-29 |
| 1417283938 | Haley Ranae Goulson | Physician Assistant | 17495 South Lagrange Road, Tinley Park, IL 60487 | 2009-10-19 |
| Find all providers in zip 60487 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902909591 | Brenda Rimando Narcelles | Pediatrics | 7060 W Centennial Dr, Suite 106, Tinley Park, IL 60477 | 2006-09-07 |
| 1689686529 | Wafaa G Hanna | Pediatrics | 18210 La Grange Rd Ste 109, Tinley Park, IL 60477-7723 | 2006-08-12 |
| 1396719803 | Kaushik Jayantilal Pandya | Pediatrics | 17029 Harlem Ave, Tinley Park, IL 60477-2739 | 2006-02-14 |
| 1053319111 | Gene Denning | Pediatrics | 18210 La Grange Rd, Suite 205, Tinley Park, IL 60477-7722 | 2005-07-12 |
| 1457358574 | Evan B Suan | Pediatrics | 6720 167th St, Tinley Park, IL 60477-2872 | 2005-07-05 |
| 1467735282 | Allison Croucher | Pediatrics | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2011-09-28 |
| 1871763342 | Healthy Kids,sc | Pediatrics | 18210 La Grange Rd Ste 109, Tinley Park, IL 60487-7723 | 2008-03-11 |
| 1700092574 | Katherine Ann Tovatt | Pediatrics | 18210 La Grange Rd, Suite 205, Tinley Park, IL 60477-7722 | 2007-05-16 |
| 1902947567 | Vera R Davis | Pediatrics | 7600 183rd St, Tinley Park, IL 60477-3690 | 2007-02-08 |
| 1184679979 | Ebs Pediatrics | Pediatrics | 6720 167th St, Tinley Park, IL 60477-2872 | 2006-05-23 |
| Find all providers in TINLEY PARK | ||||
| City | TINLEY PARK |
| Zip Code | 60487 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.