MR. KEVIN JOHN RUSSELL (NPI# 1366543167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366543167 |
| Entity Type | Individual |
| Full Name | MR. KEVIN JOHN RUSSELL |
| Credential | LCPC |
| Practice Address |
5435 Bull Valley Rd Ste 106 Mchenry IL 60050-2209 |
| Practice Telephone | 8153828378 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-09-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180002771 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558759480 | Kevin D Russell Sr. | Driver | 1351 Gates Rd, Columbia, MS 39429-8948 | 2014-12-30 |
| 1598065070 | Kevin E Russell | Pharmacist | 3308 Nw Southview Dr, Albany, OR 97321 | 2010-10-29 |
| 1558592675 | Kevin Leigh Russell | Military Health Care Provider | Msron-6, Bldg 15, Norfolk Naval Shipyard, Portsmouth, VA 23709 | 2009-08-06 |
| 1194905257 | Kevin Joseph Russell | Optometrist | 2048 E. Baseline Rd., Suite C6, Mesa, AZ 85204 | 2007-11-06 |
| 1851899694 | Kevin Laron Russell | Behavior Technician | 75 Park Creek Dr, Clovis, CA 93611-4432 | 2018-01-26 |
| 1659512978 | Kevin Russell | Marriage & Family Therapist | 1030 2nd St, Santa Rosa, CA 95404-6607 | 2009-03-17 |
| 1780722868 | Kevin L. Russell | Preventive Medicine | 34800 Bob Wilson Dr, Nmcsd, San Diego, CA 92134-1098 | 2007-02-02 |
| 1881601318 | Kevin T Russell | Physical Therapist | 111 Goose Lane, Ste 2500, Guilford, CT 06437 | 2006-08-01 |
| Street Address |
5435 BULL VALLEY RD STE 106 |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-2209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912471129 | Stephanie Lafontaine | Counselor | 4318 W Crystal Lake Road, Suite L, Mchenry, IL 60050-4250 | 2019-01-22 |
| 1376905265 | Lowell Kivley | Counselor | 501 N Dale Ave, Mchenry, IL 60050-5637 | 2016-03-22 |
| 1881038214 | Lindy Lange | Counselor | 4318 W Crystal Lake Rd Ste L, Mchenry, IL 60050-4250 | 2013-04-29 |
| 1508164617 | Sandra Terese Montalvo | Counselor | 3941 W Dayton St, Mchenry, IL 60050-8377 | 2011-03-14 |
| 1104078096 | Richard William Schupner | Counselor | 5419 Bull Valley Rd, Mchenry, IL 60050-7410 | 2008-10-22 |
| 1396913927 | Jeffrey R Weishaar | Counselor | 2012 Crooked Tree Ct, Mchenry, IL 60050-3993 | 2008-02-17 |
| 1316141799 | Cathy Smith-wenska | Counselor | 615 Hilltop Blvd, Mchenry, IL 60050-8392 | 2007-06-12 |
| 1609483643 | Haley Kramer | Counselor | 5435 Bull Valley Rd Ste 230, Mchenry, IL 60050-7435 | 2020-09-24 |
| 1801408182 | Betty Villagomez | Counselor | 5404 W Elm St Ste H, Mchenry, IL 60050-4007 | 2020-08-19 |
| 1083230007 | Risa Lynette Becker | Counselor | 5435 Bull Valley Rd Ste 230, Mchenry, IL 60050-7435 | 2020-06-25 |
| Find all providers in MCHENRY | ||||
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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.