Provider Demographics
NPI:1972612711
Name:OLSON, TRACEY LYNN (LCSW MSW)
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:LYNN
Last Name:OLSON
Suffix:
Gender:F
Credentials:LCSW MSW
Other - Prefix:MS
Other - First Name:TRACEY
Other - Middle Name:LYNN
Other - Last Name:WHALEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:130 DURANGO DR
Mailing Address - Street 2:
Mailing Address - City:GILBERTS
Mailing Address - State:IL
Mailing Address - Zip Code:60136-4084
Mailing Address - Country:US
Mailing Address - Phone:847-884-6213
Mailing Address - Fax:847-884-6687
Practice Address - Street 1:1 ILLINOIS BLVD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-3314
Practice Address - Country:US
Practice Address - Phone:847-884-6213
Practice Address - Fax:847-884-6687
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical