Active NPI
Leslie W Russell, R . PH.
- Pharmacist
- Mount Vernon, IL
National Provider Identifier
1275526782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- Practice address
- 415 S 42ND St
Mount Vernon, IL 62864-6266 - Phone
- (618) 244-9660
- Fax
- (618) 244-9551
- NPI assigned
- Aug 30, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IL | Primary |
Addresses
Primary practice location
415 S 42ND St
Mount Vernon, IL 62864-6266
Mailing address
13441 Ash Rd
Richview, IL 62877-1112
Phone (618) 322-4894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-030580 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1275526782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13441 ASH RD",
"city": "RICHVIEW",
"state": "IL",
"postal_code": "628771112",
"telephone_number": "618-322-4894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 S 42ND ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628646266",
"telephone_number": "618-244-9660",
"fax_number": "618-244-9551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "LESLIE",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "R . PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.