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Individual

DR. TRACY A LEWIS-TODD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1871 HICKS RD, SUITE A, ROLLING MEADOWS, IL 60008-1215
(847) 469-7300
(877) 885-1438
Mailing address
1228 EMERSON ST UNIT 503, EVANSTON, IL 60201-3819
(847) 769-7300
(877) 885-1438

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071003414
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21622467
BLUECROSS
IL
Enumeration date
07/31/2006
Last updated
02/19/2016
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