Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Trae A Russell, RPH

Individual provider Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · NPI 1871874255

Mr. Trae A Russell, RPH is a Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois and Ohio.

Licensed in
IL, OH
In the registry since
2011
Specialties on file
4
What do these letters mean?
RPH — Registered Pharmacist
A pharmacist licensed by a state board.

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Practice location Address checks out

5440 N Clark St
Chicago, IL 60640-1210
Phone: (773) 596-5022
Fax: (773) 506-3837
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 03324175 (OH)
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Taxonomy 1835P0018X · Licence 051306217 (IL)
Pharmacist Taxonomy 183500000X · Licence 051.306217 (IL)
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Taxonomy 1835P0018X · Licence 03324175 (OH)

Record details

NPI number1871874255
Entity typeIndividual (Type 1)
GenderMale
Credentials RPH
Sole proprietorYes
NPI enumeratedAugust 30, 2011
Last updated in NPPESNovember 8, 2025
Certification dateNovember 8, 2025

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