Individual
TRACY JORGENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
582 N HAVERHILL LN, SOUTH ELGIN, IL 60177-3208
(847) 721-7432
Mailing address
582 N HAVERHILL LN, SOUTH ELGIN, IL 60177-3208
(847) 721-7432
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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