Individual
TRACY RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT,CCCE,CCI
Contact information
Practice address
900 N 2ND ST, ROCHELLE, IL 61068-1764
(815) 758-0000
(815) 748-3014
Mailing address
1952 ABERDEEN CT, SYCAMORE, IL 60178-3175
(815) 758-0000
(815) 748-3014
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
070016939
IL
2251X0800X
Orthopedic Physical Therapist
Primary
070-016939
IL
Other
Enumeration date
06/26/2012
Last updated
11/16/2017
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