Provider Demographics
NPI:1407179930
Name:BARWICK, TRACIE PASQUINELLI
Entity Type:Individual
Prefix:MRS
First Name:TRACIE
Middle Name:PASQUINELLI
Last Name:BARWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TRACIE
Other - Middle Name:ANNE
Other - Last Name:PASQUINELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16567 PASTURE DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4578
Mailing Address - Country:US
Mailing Address - Phone:630-243-7084
Mailing Address - Fax:
Practice Address - Street 1:14236 MCCARTHY RD
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-9393
Practice Address - Country:US
Practice Address - Phone:708-203-5668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist