Provider Demographics
NPI:1508062761
Name:MCKINNEY, TRICIA A (PSYD)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:A
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 N WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4252
Mailing Address - Country:US
Mailing Address - Phone:847-791-2851
Mailing Address - Fax:
Practice Address - Street 1:2030 E ALGONQUIN RD
Practice Address - Street 2:SUITE 401
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4188
Practice Address - Country:US
Practice Address - Phone:847-791-2851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007795103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent