Individual
DR. TRACI E. POWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9415 S WESTERN AVE, STE 201A, CHICAGO, IL 60620-6230
(773) 779-9700
(773) 779-9732
Mailing address
2944 W 86TH PL, CHICAGO, IL 60652-3830
(773) 471-7795
(773) 471-7796
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
06/20/2005
Last updated
07/08/2007
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