| NPI | 1174510978 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-10-05 |
| Last Updated | 2022-01-04 |
| Mailing Address | 1118 Legacy Pointe Dr Springfield, IL 62711 United States Phone: (217) 787-8870 | Fax: (217) 787-6158 📍 View Map |
| Primary Practice Address | 1118 Legacy Pointe Dr Springfield, IL 62711 United States Phone: (217) 787-8870 | Fax: (217) 787-6158 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | IL | 020057300 | BLACK LUNG |
| MEDICAID | IL | 036102799 | - |
| Other (non-Medicare) | IL | 08421024 | BLUE CROSS BLUE SHIELD |
| Other (non-Medicare) | IL | 14D0949277 | CLIA CERT |
| Other (non-Medicare) | IL | 6394P | CATERPILLAR |
| Other (non-Medicare) | IL | CD7143 | RR MEDICARE GRP |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207RE0101X – Internal Medicine, Endocrinology, Diabetes & Metabolism | IL | 036102799 |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1174510978
Marina K Russo MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174510978. The primary specialty listed is Internal Medicine, Endocrinology, Diabetes & Metabolism. The provider is located in Springfield, IL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-10-05. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174510978?
NPI 1174510978 belongs to Marina K Russo MD, a Internal Medicine, Endocrinology, Diabetes & Metabolism in Springfield, IL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174510978 active?
The current status of NPI 1174510978 in the NPPES registry is Active. The record was last updated on 2022-01-04.
What specialty is NPI 1174510978?
NPI 1174510978 is classified under the taxonomy Internal Medicine, Endocrinology, Diabetes & Metabolism. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1174510978?
You can verify NPI 1174510978 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1174510978?
The primary practice address on file for NPI 1174510978 is 1118 Legacy Pointe Dr, Springfield, IL 62711. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174510978 issued?
NPI 1174510978 was first issued (enumerated) on 2005-10-05. The NPPES record was last updated on 2022-01-04.
Practice Location Map
Marina K Russo is located at 1118 Legacy Pointe Dr, Springfield, IL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Marina K Russo. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174510978. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Internal Medicine, Endocrinology, Diabetes & Metabolism | 036102799 | IL |