Hall, Tracy L
Hall, Tracy L is an individual health care provider with primary practice located at 201 Health Care Dr , Greenville IL 62246-1155. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Hall, Tracy L can be contacted via phone (618) 664-1380.Contact Information
Primary practice address
201 Health Care Dr
Greenville IL 62246-1155
Phone: (618) 664-1380
Fax: (618) 664-4239
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 036083073 | Illinois |
Profile Details
| NPI number | 1659366102 |
|---|---|
| LBN Legal business name | Hall, Tracy L |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2005 |
| Last updated | Dec 27th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659366102 | NPPES |
| Illinois | MEDICAID | 036083073 |
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