Michael Russell

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.480622 Issued in IL

Practice address

1620 W Harrison St
Chicago, IL 60612-3801

Phone

(815) 531-7382

NPI assigned

Apr 14, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Michael Russell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1376338038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25408 S MALLARD DR",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604109710",
            "telephone_number": "815-531-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801",
            "telephone_number": "815-531-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.480622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "RUSSELL",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Marcus Edward Russell
• Margaret Russell, MD
• Mary Kathleen Russell, M.D.
• Mary Krystofiak Russell, RD
• Meagan Russell
• Michael Guy Russell, LCSW
• Nicole Russell
• Sarah Russell, MA, LCPC, NCC
• Stevnika Russell
• Susan Renee Russell, M.D.

• Registered Nurse in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.