Georgeann L Iacono Russell, PHD | |
7411 West Lake Street, Building A, Suite L120, River Forest, IL 60305-1876 | |
(708) 488-1919 | |
(708) 763-2120 |
Full Name | Georgeann L Iacono Russell |
---|---|
Gender | Female |
Speciality | Clinical Psychologist |
Experience | 33 Years |
Location | 7411 West Lake Street, River Forest, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164552154 | NPI | - | NPPES |
21623162 | Other | IL | BCBS GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 071-004593 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Resilience Healthcare - Lakefront Medical Associates Llc | 5991046468 | 49 |
Entity Name | Resilience Healthcare - Lakefront Medical Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205301926 PECOS PAC ID: 5991046468 Enrollment ID: O20190410000827 |
Mailing Address | Practice Location Address |
---|---|
Georgeann L Iacono Russell, PHD 1825 De Forest Ln, Hanover Park, IL 60133-5905 Ph: (630) 837-8028 | Georgeann L Iacono Russell, PHD 7411 West Lake Street, Building A, Suite L120, River Forest, IL 60305-1876 Ph: (708) 488-1919 |
Sappho Risner, NCSP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1533 William St Apt 2e, River Forest, IL 60305 Phone: 773-383-5763 | |
Dr. Robert Barry Lees, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 239 Forest Ave, River Forest, IL 60305 Phone: 708-488-1898 | |
Dr. Carlissa Richards Hughes, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 605 Keystone Ave, River Forest, IL 60305 Phone: 312-531-2375 | |
Dr. Thomas J Rostafinski, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 7627 Lake St Ste 215, River Forest, IL 60305 Phone: 708-848-1611 Fax: 708-848-1436 | |
Dr. John Edward Mundt, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1523 William St, River Forest, IL 60305 Phone: 312-608-0668 |