TRACEY BLANCHARD (NPI# 1306336144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306336144 |
| Entity Type | Individual |
| Full Name | TRACEY BLANCHARD |
| Practice Address |
5911 Northwest Hwy Ste 207 Crystal Lake IL 60014-8043 |
| Practice Telephone | 8155263781 |
| Mailing Telephone | 8155263781 |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 043118421 | IL | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSED PRACTICAL NURSE | 043118421 | 01 |
| Street Address |
5911 NORTHWEST HWY STE 207 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-8043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407343304 | Angela Perillo | Counselor | 5911 Northwest Hwy Ste 207, Crystal Lake, IL 60014-8043 | 2018-04-16 |
| 1861987604 | Lisa M Trautman | Nurse Practitioner | 5911 Northwest Hwy Ste 207, Crystal Lake, IL 60014-8043 | 2018-06-25 |
| 1982193181 | Gail A Hellebuyck | Registered Nurse | 5911 Northwest Hwy Ste 207, Crystal Lake, IL 60014-8043 | 2018-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477742468 | Leslie Faye Mann | Licensed Practical Nurse | 440 S Mchenry Ave, Crystal Lake, IL 60014-7147 | 2007-10-16 |
| 1144418963 | Karin M Hans | Licensed Practical Nurse | 440 S Mchenry Ave, Crystal Lake, IL 60014-7147 | 2007-10-05 |
| 1225226269 | Sharon Ruth Swan | Licensed Practical Nurse | 440 S Mchenry Ave, Crystal Lake, IL 60014-7147 | 2007-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330233 | Candace D Younger | Licensed Practical Nurse | 507 Lickliter St, Benton, IL 62812-2219 | 2020-09-15 |
| 1063025781 | Austin Grant | Licensed Practical Nurse | 205 Joplin St, Benton, IL 62812-2023 | 2020-08-24 |
| 1518570233 | Titilayo Ayeni-sode | Licensed Practical Nurse | 23025 Amber Ln, Richton Park, IL 60471-1281 | 2020-08-24 |
| 1477164929 | Monique L Lee | Licensed Practical Nurse | 8528 S Exchange Ave # 2, Chicago, IL 60617-2541 | 2020-08-10 |
| 1619597291 | Robin Wilson | Licensed Practical Nurse | 842 S 18th Ave, Maywood, IL 60153-1706 | 2020-04-23 |
| 1790319630 | Krystle Ekhoff | Licensed Practical Nurse | 9108 S Troy Ave, Evergreen Park, IL 60805-1628 | 2020-03-01 |
| 1932732237 | Robina Renee Williams | Licensed Practical Nurse | 16313 Turner Ave, Markham, IL 60428-5446 | 2020-02-15 |
| 1417589649 | Lataunja Parese Weaver | Licensed Practical Nurse | 7436 S Ellis Ave, Chicago, IL 60619-2032 | 2020-02-05 |
| 1124667621 | Jacquelyn Cooper | Licensed Practical Nurse | 230 N Lind Ave, Hillside, IL 60162-1538 | 2019-12-31 |
| 1699312587 | Kristi Ann Pittman-spero | Licensed Practical Nurse | 101 N Jefferson Ave, Bradley, IL 60915-1829 | 2019-12-10 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.