Individual
MRS. TRACY MARIA VINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 W 122ND PL, CHICAGO, IL 60643-5301
(773) 983-4626
Mailing address
1550 W 122ND PL, CHICAGO, IL 60643-5301
(773) 983-4626
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041330108
IL
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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