Individual
MRS. TRACY J BALOUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
509 LONGTREE DRIVE, WHEELING, IL 60090
(847) 947-2102
Mailing address
509 LONGTREE DRIVE, WHEELING, IL 60090
(847) 947-2102
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
JB64100107P
IL
Other
Enumeration date
01/02/2008
Last updated
01/02/2008
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