Peter Anthony Russo, OD | |
2160 S 1st Ave, (17w740 22nd Steert, Oakbrook Terrace, Il. 60181), Maywood, IL 60153 | |
(630) 627-7399 | |
(630) 627-7079 |
Full Name | Peter Anthony Russo |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 2160 S 1st Ave, Maywood, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790759694 | NPI | - | NPPES |
46008021 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 46008021 (Illinois) | Primary |
Provider Name | Loyola University Medical Center |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1336159961 PECOS PAC ID: 3779488903 Enrollment ID: O20031202000027 |
Mailing Address | Practice Location Address |
---|---|
Peter Anthony Russo, OD 2160 S 1st Ave, (17w740 22nd Steert, Oakbrook Terrace, Il. 60181), Maywood, IL 60153 Ph: (630) 627-7399 | Peter Anthony Russo, OD 2160 S 1st Ave, (17w740 22nd Steert, Oakbrook Terrace, Il. 60181), Maywood, IL 60153 Ph: (630) 627-7399 |
Eileen M Gable, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 Fax: 708-216-4878 | |
New Wilson Optical Optometrist Medicare: Not Enrolled in Medicare Practice Location: 217 S 5th Ave # B, Maywood, IL 60153 Phone: 708-345-4040 Fax: 708-345-5534 | |
Dr. Megan Ann Hunter, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
Ms. Neelam Patadia, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 888-584-7888 |