Individual
DR. TRACY LYNN IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV PED ALLERGY/IMMUNO/PULMO, SAINT LOUIS, MO 63110-1002
(314) 454-2694
(314) 454-2515
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-2694
(314) 454-2515
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2015008494
MO
2080P0214X
Pediatric Pulmonology Physician
Primary
2015008494
MO
2080S0012X
Pediatric Sleep Medicine Physician
2015008494
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200031877
—
MO
Enumeration date
05/11/2009
Last updated
04/17/2025
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