MS. TRACEY LATONYA BLACKBURN (NPI# 1629551304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629551304 |
| Entity Type | Individual |
| Full Name | MS. TRACEY LATONYA BLACKBURN |
| Practice Address |
1717 Rand Rd Des Plaines IL 60016-3509 |
| Mailing Address |
1800 N Hermitage Ave Chicago IL 60622-1161 |
| Practice Telephone | 7732945797 |
| Mailing Telephone | 7732945797 |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 362170821061 | 05 |
| Street Address |
1717 RAND RD |
| City | DES PLAINES |
| State | IL |
| Zip Code | 60016-3509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922430073 | Cheryl L Joseph-lukz | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2013-07-31 |
| 1558849489 | Elizabeth Hoffman | Social Worker | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2018-08-02 |
| 1457862997 | Angelica Lopez | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2017-10-23 |
| 1437686748 | Mary Amanda Myers | Social Worker | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2017-05-17 |
| 1144768284 | Bianca Galvez | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2017-02-09 |
| 1639520018 | Vivian Eseoghene Deniran | Social Worker | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2016-06-27 |
| 1407204290 | David L Mccoy Sr. | Social Worker | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2016-06-02 |
| 1609224583 | Latisha Wright | Case Management | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2016-06-01 |
| 1770931800 | Kenneth Keibler | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2016-05-31 |
| 1174971220 | Carmen Guerrero | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2016-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043702830 | Professional Healthcare Inc | Family Medicine | 960 Rand Rd Ste 224, Des Plaines, IL 60016 | 2018-06-06 |
| 1407367022 | Vcare Pharmacy Inc | Pharmacy | 380 E Nortwest Hwy, Suite 201, Des Plaines, IL 60016 | 2017-10-23 |
| 1649799610 | George N Hotousiotis | Pharmacist | 10 East Golf Road, Des Plaines, IL 60016 | 2017-09-11 |
| 1619494838 | Abdul M Shamsuddin | Physical Therapist | 2555 Suffield St, Des Plaines, IL 60016 | 2017-08-28 |
| 1063960482 | Rachel Kimbrough | Counselor | 100 N River Road, Des Plaines, IL 60016 | 2016-09-14 |
| 1902250178 | Perfect Storm Chiropractic, LLC | Chiropractor | 565 Concord Ln, Des Plaines, IL 60016 | 2016-04-14 |
| 1255796611 | Nektaria Goudis | Psychologist | 950 Lee Street, Des Plaines, IL 60016 | 2015-12-29 |
| 1831501352 | Gary R. Kuntz | Dentist | 1173 Algonquin Rd., Des Plaines, IL 60016 | 2014-06-02 |
| 1558773754 | Midwest Anesthesia and Pain Specialists, Sc | Pain Medicine | 9700 Golf Rd, Second Floor, Des Plaines, IL 60016 | 2014-05-22 |
| 1508282377 | Maciej Padowski | Emergency Medicine | 9500 Greenwood Dr, Des Plaines, IL 60016 | 2014-03-17 |
| Find all providers in zip 60016 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396380929 | Edilberto Sison Bibat Jr. | Counselor | 1585 Ellinwood Ave # Stl11, Des Plaines, IL 60016-4510 | 2019-11-06 |
| 1063960482 | Rachel Kimbrough | Counselor | 100 N River Road, Des Plaines, IL 60016 | 2016-09-14 |
| 1639229552 | Karen L Hagen | Counselor | 465 W Walnut Ave, Des Plaines, IL 60016-5815 | 2007-01-11 |
| 1457862997 | Angelica Lopez | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2017-10-23 |
| 1144768284 | Bianca Galvez | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2017-02-09 |
| 1285176966 | Tyler Jones | Counselor | 1001 E Touhy Ave, Des Plaines, IL 60018-5801 | 2016-11-10 |
| 1134577661 | Allison Grant | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2016-05-25 |
| 1457708117 | Lori Greenman | Counselor | 1400 E Touhy Ave Ste 240, Des Plaines, IL 60018-3316 | 2016-05-23 |
| 1255706214 | Ma Beatriz Camasosa | Counselor | 1717 Rand Rd, Des Plaines, IL 60016-3509 | 2015-12-02 |
| 1790183390 | Rebecca Lee | Counselor | 1455 E Golf Rd Ste 105, Des Plaines, IL 60016-1253 | 2014-12-12 |
| Find all providers in DES PLAINES | ||||
| City | DES PLAINES |
| Zip Code | 60016 |
Please comment or provide details below to improve the information on MS. TRACEY LATONYA BLACKBURN.
| 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.