TRACY PACKER (NPI# 1942857222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942857222 |
| Entity Type | Individual |
| Full Name | TRACY PACKER |
| Practice Address |
200 E Fairman Ave Watseka IL 60970-1644 |
| Practice Telephone | 8154325841 |
| Mailing Telephone | 2176216360 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-10-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209018658 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 E FAIRMAN AVE |
| City | WATSEKA |
| State | IL |
| Zip Code | 60970-1644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497748040 | Vijay Desai | Emergency Medicine | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2005-08-30 |
| 1861015232 | Holly Isaac | Dietitian, Registered | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2020-05-20 |
| 1194357954 | Alliance Medical Partners, LLC | Emergency Medicine | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2020-02-10 |
| 1891326286 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2020-02-04 |
| 1003396318 | Aaron Daniel Mccray | Nurse Practitioner | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2018-08-16 |
| 1144760836 | Rebecca Koerner | Nurse Practitioner | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2017-03-01 |
| 1083066674 | Iroquois Memorial Hospital | Surgery | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2016-07-07 |
| 1376929174 | Brotula Emergency Physicians LLC | Emergency Medicine | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2015-08-04 |
| 1093191173 | Amy Johandes | Nurse Practitioner | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2015-07-30 |
| 1770982464 | Jessica A. Morales | Registered Nurse | 200 E Fairman Ave, Watseka, IL 60970-1644 | 2014-08-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376189167 | Malinda S Mustered | Occupational Therapist | 825 S Belmont Ave, Watseka, IL 60970 | 2019-11-27 |
| 1558889188 | K-shayla Lafayette | Nurse Practitioner | 200 E. Fairman Ave., Watseka, IL 60970 | 2017-09-04 |
| 1144354879 | Pamela H. Beall | Counselor | 1801 N. State Route 1, Suite 2, Watseka, IL 60970 | 2007-03-15 |
| 1528111879 | Spine Clinics of America Sc | Chiropractor | 425 E. Walnut Street, Watseka, IL 60970 | 2007-01-19 |
| 1699833970 | Shakeel Sher Khan Sandozi | Surgery | 625 S Fifth Street, Watseka, IL 60970 | 2006-12-05 |
| 1790859866 | David Charles Nagele | Dentist | 130 N Littelfuse Ln, Suite 101, Watseka, IL 60970 | 2006-11-20 |
| 1942389259 | John M Rose | Dentist | 316 E Lincoln Ave, Watseka, IL 60970 | 2006-11-06 |
| 1952324279 | Bonita Jean Rajala | Counselor | 617 East Grant St., Watseka, IL 60970 | 2006-07-26 |
| 1396978177 | Allison Shindelar | Social Worker | 323 Wmulberry St, Watseka, IL 60970-0332 | 2009-08-27 |
| 1356441539 | Petersen Health Operations, LLC | Skilled Nursing Facility | 900 N Market St, Watseka, IL 60970-1048 | 2006-09-25 |
| Find all providers in zip 60970 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295032720 | Dianne Schoolman | Nurse Practitioner | 625 S 5th St, Ste B, Watseka, IL 60970-1863 | 2011-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578523 | Kaitlin Lawson Kalnitz | Nurse Practitioner | 745 Mcclintock Dr Ste 360, Burr Ridge, IL 60527-0875 | 2020-11-06 |
| 1841890290 | Maria Malanych | Nurse Practitioner | 5731 Rosinweed Ln, Naperville, IL 60564-1635 | 2020-10-27 |
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1295334811 | Mary Farley | Nurse Practitioner | 7308 Northwood Dr, Wonder Lake, IL 60097-8606 | 2020-10-24 |
| 1164021168 | Stephanie Schuster | Nurse Practitioner | 2665 Prairieview Ln N, Aurora, IL 60502-6343 | 2020-10-21 |
| 1316546641 | Vanessa K Bajaj | Nurse Practitioner | 1123 N Claremont Dr, Palatine, IL 60074-4002 | 2020-10-19 |
| 1003414442 | Gachugu Medical Clinic | Nurse Practitioner | 1 E Ferguson Ave, Wood River, IL 62095-1903 | 2020-10-16 |
| 1477151272 | Yolanda K Bradford | Nurse Practitioner | 2700 S California Ave, Chicago, IL 60608-5108 | 2020-10-14 |
| 1265030019 | Andrea Mclean | Nurse Practitioner | 2500 W Reynolds St # 205, Pontiac, IL 61764-9774 | 2020-10-14 |
| 1558968628 | Timothy Nenoff | Nurse Practitioner | 24722 Lincolnway St, Plainfield, IL 60544-2412 | 2020-10-02 |
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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.