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Individual

MS. TRACY TINA HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8302-10 SOUTH PAULINA, CHICAGO, IL 60620
(773) 239-0047
(773) 239-0047
Mailing address
PO BOX 20208, CHICAGO, IL 60620-0208
(773) 239-0047
(773) 239-0047

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2216698
IL

Other

Enumeration date
09/16/2007
Last updated
08/13/2015
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