Provider Demographics
NPI:1518067271
Name:COURTICE, LINDA RUSSELL (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:RUSSELL
Last Name:COURTICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2993 CURTIS ST
Mailing Address - Street 2:#10
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5626
Mailing Address - Country:US
Mailing Address - Phone:847-824-4322
Mailing Address - Fax:
Practice Address - Street 1:2993 CURTIS ST
Practice Address - Street 2:#10
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-5626
Practice Address - Country:US
Practice Address - Phone:847-824-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041184344163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse