Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Robert Carson Russell, DO

Individual provider Emergency Medicine Physician · NPI 1710620927

Robert Carson Russell, DO is an Emergency Medicine in Peoria, Illinois. Qualified in 2022, 4 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2022
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-2109
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 036173028 (IL)

Record details

NPI number1710620927
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 15, 2022
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025
Mailing address530 Ne Glen Oak Ave, Peoria, IL 61637-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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