Walters, Traci
Walters, Traci is an sole proprietor health care provider with primary practice located at 1415 W 47Th St , La Grange IL 60525-6136. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Walters, Traci can be contacted via phone (219) 878-5050.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 085.005340 | Illinois |
Profile Details
| NPI number | 1134519465 |
|---|---|
| LBN Legal business name | Walters, Traci |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 26th, 2015 |
| Last updated | Apr 13th, 2021 - about 4 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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