Provider Demographics
NPI:1609901636
Name:FINK, TRACY JO (ATC)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:JO
Last Name:FINK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-2855
Mailing Address - Country:US
Mailing Address - Phone:630-250-9984
Mailing Address - Fax:
Practice Address - Street 1:984 WILLOW ST
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143-2855
Practice Address - Country:US
Practice Address - Phone:630-250-9984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer