Trae A Russell, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

03324175 Issued in OH

Practice address

5440 N Clark St
Chicago, IL 60640-1210

Phone

(773) 596-5022

Fax

(773) 506-3837

NPI assigned

Aug 30, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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

• Walgreen Co

  • Pharmacy
  • Massillon, OH
  • NPI 1609881655
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762560000000",
    "number": "1871874255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401210",
            "telephone_number": "773-596-5022",
            "fax_number": "773-506-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401210",
            "telephone_number": "773-596-5022",
            "fax_number": "773-506-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "TRAE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-30",
        "last_updated": "2025-11-08",
        "certification_date": "2025-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051306217",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03324175",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.306217",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "03324175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Guy Russell, LCSW
• Nicole Russell
• Sarah Russell, MA, LCPC, NCC
• Stevnika Russell
• Susan Renee Russell, M.D.
• Douglas Russo, MD
• Hannah Russo
• Margaret Jean Russo, RN
• Maurice Dominic Russo, D.D.S.
• Renee Russo

• Pharmacist in Chicago, IL
• Providers in Chicago, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.