Provider Demographics
NPI:1245896067
Name:CONNOR, TRACY LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LYNN
Last Name:CONNOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:KEENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9740 S SEELEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1640
Mailing Address - Country:US
Mailing Address - Phone:773-551-1689
Mailing Address - Fax:
Practice Address - Street 1:9740 S SEELEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1640
Practice Address - Country:US
Practice Address - Phone:773-551-1689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical