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Active NPI 1104237130 Individual Practitioner Male Practitioner

John Russell

Nurse Practitioner • Rockford, IL

Professional Overview & Biography Verified Profile Summary

John Russell is a registered healthcare professional specializing in Nurse Practitioner in Rockford, IL. Practice services are available at 1340 CHARLES ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1340 Charles St
Suite 300

Rockford, IL 61104

Telephone 7796968800
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Rockford, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.7 Yrs
State Avg: 10.4 Yrs
Regional Practice Density
130 Specialists

Practicing in Rockford, IL (4929 Statewide)

Telehealth Adoption Rate
13.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-11-26
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IL 277-000310

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Nurse Practitioner

NUCC Taxonomy Code: 363L00000X

State License IL 209-011657

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Registered Nurse

NUCC Taxonomy Code: 163W00000X

State License IL 041.368559

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. John Myers , MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NPI 1174553523

Doctor of Medicine (M.D.)

Rebecca Behling , FNP

Nurse Practitioner

NPI 1508060518

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 26, 2021

Nurse Practitioner (License #209-011657 in IL)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2021

Registered Nurse (License #041.368559 in IL)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 19, 2021

Nurse Practitioner (License #209-011657 in IL)

📍
Updated Practice Location July 27, 2018

Registered at 1340 CHARLES ST, SUITE 300, ROCKFORD, IL 61104 (Tel: 7796968800)

📍
Updated Business Mailing Address July 27, 2018

Registered at PO BOX 78866, MILWAUKEE, WI 532788866 (Tel: 7796967150)

NPI Profile Active April 14, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location April 14, 2016

Registered at 1340 CHARLES ST, SUITE 300, ROCKFORD, IL 611042200 (Tel: 7796968800)

📍
Updated Business Mailing Address April 14, 2016

Registered at PO BOX 1567, ROCKFORD, IL 611100067

👤
Provider Name / Credentials Updated April 14, 2016

Recorded as JOHN RUSSELL

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 14, 2016

Registered Nurse (License #041.368559 in IL)

🟢
Initial NPI Registration & Enumeration May 13, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104237130
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 13, 2014
Last Update: November 26, 2021
Sole Proprietor: No

Mailing Address

Po Box 78866

Milwaukee, WI 532788866

Phone: 7796967150

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.