Doctor Name: | ANDY JOHN TRACY |
NPI Number: | 1295923985 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRNA |
License Number: | |
Business Practice Address: | 3300 Greenbriar Ln Midwest Anesthesiologists Riverwoods, IL - 600153857 |
Business Phone Number: | 7735508290 |
Business Fax Number: | |
Mailing Address: | 3300 Greenbriar, Midwest Anesthesiologits RIVERWOODS |
State: | IL |
Postal Code: | 60015 |
Phone Number: | 7735508290 |
Fax Number: | |
NPI Enumeration Date: | 10/09/2007 |
NPI Last Update Date: | 03/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Critical Care Medicine |
Taxonomy Definition: |