Individual
PATRICK TERENCE TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 624-4000
(309) 624-4010
Mailing address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 624-4000
(309) 624-4010
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036069397
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069397
—
IL
Enumeration date
05/24/2006
Last updated
03/02/2016
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