Provider Demographics
NPI:1508857905
Name:HASHEMI, TRACEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:L
Last Name:HASHEMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TRACEY
Other - Middle Name:L
Other - Last Name:MCINTYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:405 LAKE ZURICH RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3141
Mailing Address - Country:US
Mailing Address - Phone:847-381-5599
Mailing Address - Fax:847-381-8042
Practice Address - Street 1:405 LAKE ZURICH RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3141
Practice Address - Country:US
Practice Address - Phone:847-381-5599
Practice Address - Fax:847-381-8042
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01087544A207P00000X
IL036095011207P00000X, 207PH0002X
MI4301505849207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095011Medicaid
ILIL3519018OtherMEDICARE PTAN
ILP01146483OtherRAILROAD MEDICARE PTAN