| Doctor Name: | TRACY L DEBOSE |
| NPI Number: | 1194020321 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149010913 |
| Business Practice Address: | 10537 S Roberts Rd Palos Hills, IL - 604651933 |
| Business Phone Number: | 7089742300 |
| Business Fax Number: | |
| Mailing Address: | 811 S Oakley Blvd, Apt 2 CHICAGO |
| State: | IL |
| Postal Code: | 606124227 |
| Phone Number: | 7089745109 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2011 |
| NPI Last Update Date: | 01/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149010913 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |