National Provider Identifier Database

TIMOTHY M RUSSO, CPO – NPI #1992206577
Prosthetist

An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both


Contact Information

TIMOTHY M RUSSO, CPO
401 HARRISON ST
OAK PARK, IL60304-1427
Phone: 708-383-2257
Fax: 708-383-0739
Website:
Specialty Taxonomy Code
* Prosthetist 224P00000X
Orthotist 222Z00000X

* Indicates primary specialty

NPI Profile & details for TIMOTHY M RUSSO

NPI Number 1992206577
Credentials CPO
Entity Individual
Enumeration date 02/28/2018
Last updated 02/28/2018 - About 8 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 211.000298
  • IL License #: 213.000337
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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