TRAE A RUSSELL

CHICAGO, IL
NPI1871874255
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: OH  03324175)
Additional Taxonomies1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
(Licence: IL  051306217)
183500000X Pharmacist
(Licence: IL  051.306217)
1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
(Licence: OH  03324175)
Enumeration Date2011-08-30
Last Update Date2025-11-08
Business Address
Mr. TRAE A RUSSELL RPh
5440 N CLARK ST
CHICAGO, IL 60640-1210
Phone number: 773-596-5022
Mailing Address
Mr. TRAE A RUSSELL RPh
5440 N CLARK ST
CHICAGO, IL 60640-1210
Phone number: 773-596-5022