| Doctor Name: | CYNTHIA MARIE RUSSELL |
| NPI Number: | 1053489450 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | 149.013675 |
| Business Practice Address: | 460 Briargate Dr Suite 700 South Elgin, IL - 601772227 |
| Business Phone Number: | 8474881999 |
| Business Fax Number: | 8474889797 |
| Mailing Address: | 331 Silverwood Ct, Unit C SCHAUMBURG |
| State: | IL |
| Postal Code: | 601932181 |
| Phone Number: | 7736293082 |
| Fax Number: | 8474889797 |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 10/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149.013675 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |