Active NPI
Russell Duane Queen
- Addiction (Substance Use Disorder) Counselor
- Blue Island, IL
National Provider Identifier
1346194040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 45454
- Practice address
- 12761 Western Ave
Blue Island, IL 60406-2141 - Phone
- (708) 606-6678
- NPI assigned
- Feb 21, 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 45454 | IL | Primary |
Addresses
Primary practice location
12761 Western Ave
Blue Island, IL 60406-2141
Mailing address
12761 Western Ave
Blue Island, IL 60406-2141
Phone (708) 606-6678
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45454 | IL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771632000000",
"number": "1346194040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12761 WESTERN AVE",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604062141",
"telephone_number": "708-606-6678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12761 WESTERN AVE",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604062141",
"telephone_number": "708-606-6678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEEN",
"first_name": "RUSSELL",
"middle_name": "DUANE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-02-21",
"last_updated": "2026-02-21",
"certification_date": "2026-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "45454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.