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Search › Illinois › 183500000X

Trae Russell, RPH

NPI 1871874255 · on the registry since 2011 · sole proprietor

Practice

Address
5440 N Clark St
Chicago, IL 60640
Phone
(773) 596-5022
Fax
(773) 506-3837
Organisation at this address
Walgreen Co
Gwa Optical Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
6

Registry record

Primary taxonomy
183500000X
183500000X
Also registered as
1835P0018X
183500000X
1835P0018X
Licence states on file
IL, OH
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-11-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois