Provider Demographics
NPI:1982726899
Name:WINN, TRACY HAGAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:HAGAN
Last Name:WINN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60208-0895
Mailing Address - Country:US
Mailing Address - Phone:847-491-3165
Mailing Address - Fax:847-467-7141
Practice Address - Street 1:2240 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60208-0895
Practice Address - Country:US
Practice Address - Phone:847-491-3165
Practice Address - Fax:847-467-0410
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000871231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist