Grotrian, Tracy L

Grotrian, Tracy L is an individual health care provider with primary practice located at 1701 W Curtis Road Family Medicine/Convenient Care, Champaign IL 61822. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Grotrian, Tracy L can be contacted via phone (217) 365-6201.

Contact Information

Primary practice address
1701 W Curtis Road Family Medicine/Convenient Care Champaign IL 61822
Phone: (217) 365-6201
Fax: (217) 326-1234
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036110788 Illinois

Profile Details

NPI number 1700809373
LBN Legal business name Grotrian, Tracy L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Nov 21st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700809373 NPPES
Illinois Other P00192495 RAILROAD
Illinois Other 0533210001 RAILROAD

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