Gillian Joell Russell

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209032192 Issued in IL

Practice address

4948 Benchmark Centre Dr
Swansea, IL 62226-2027

Phone

(618) 628-2588

Fax

(618) 628-1363

NPI assigned

Apr 22, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Musick Dermatology and Advanced Clinical Spa LLCGroup PAC ID 3577636604, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/GRzkF6yCy_Pe-6F3SJzcXkCEiy_u6zZe/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Musick Dermatology & Advanced Clinical Spa, LLC

  • Dermatology Physician
  • Swansea, IL
  • NPI 1922260587
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1417744798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 BENCHMARK CENTRE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262027",
            "telephone_number": "618-628-2588",
            "fax_number": "618-628-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4948 BENCHMARK CENTRE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262027",
            "telephone_number": "618-628-2588",
            "fax_number": "618-628-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GILLIAN",
        "middle_name": "JOELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209032192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Marie Roulanaitis, MS CCC-A
• Kayla R Roulette, MA, LCPC
• Daniel M. Rovin, D.C.
• Gary L Rovin, D.C.
• Paula Jo Rush Shumpert, DT
• Katelin Lee Ann Russell, DC
• Nadiah Sabrah, MSW, LCSW, THERAPIST
• Sacrae LLC
• John Douglas Sadoff, M.D.
• Melody Santos, M.D.

• Nurse Practitioner in Swansea, IL
• Providers in Swansea, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.