Individual
TRACY NORTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10257 W LINCOLN HWY, FRANKFORT, IL 60423-1279
(815) 469-1500
Mailing address
10257 W LINCOLN HWY, FRANKFORT, IL 60423-1279
(815) 469-1500
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
056.002009
IL
174H00000X
Health Educator
056.002009
IL
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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