Mr Ronald C Russo, MD | |
2504 Galen Drive, Suite 107, Champaign, IL 61821-7048 | |
(217) 398-4856 | |
(217) 373-5214 |
Full Name | Mr Ronald C Russo |
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Gender | Male |
Speciality | Surgery - Plastic And Reconstructive Surgery |
Location | 2504 Galen Drive, Champaign, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447380985 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0122X | Surgery - Plastic And Reconstructive Surgery | (Illinois) | Primary |
Entity Name | Carle Health Care Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
Mailing Address | Practice Location Address |
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Mr Ronald C Russo, MD 2504 Galen Drive, Suite 107, Champaign, IL 61821-7048 Ph: (217) 398-4856 | Mr Ronald C Russo, MD 2504 Galen Drive, Suite 107, Champaign, IL 61821-7048 Ph: (217) 398-4856 |
Donna L Decamara, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1702 S Mattis Ave, Champaign, IL 61821 Phone: 217-326-2000 | |
Dr. Harry Reed Thompson Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 413 E University Ave, Champaign, IL 61820 Phone: 217-359-9601 Fax: 217-359-9609 | |
Dr. Paul Wetstein, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3105 Fields South Dr, Champaign, IL 61822 Phone: 217-383-3240 | |
Dr. Nirmal Gokarn, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3101 Fields South Dr, Champaign, IL 61822 Phone: 217-366-1228 Fax: 718-798-0730 | |
Mattie Arseneaux, Surgery Medicare: Not Enrolled in Medicare Practice Location: 3105 Fields South Dr, Champaign, IL 61822 Phone: 217-383-3240 | |
Daniel Suarez, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3105 Fields South Dr, Champaign, IL 61822 Phone: 217-902-2100 | |
Bethany Briggs, D.O. Surgery Medicare: Medicare Enrolled Practice Location: 3105 Fields South Dr, Champaign, IL 61822 Phone: 217-383-3240 |