Blackburn, Tracee A

Blackburn, Tracee A is an sole proprietor health care provider with primary practice located at 1460 North Halsted Street Suite 505, Chicago IL 60642. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Blackburn, Tracee A can be contacted via phone (312) 266-6462.

Contact Information

Primary practice address
1460 North Halsted Street Suite 505 Chicago IL 60642
Phone: (312) 266-6462
Fax: (312) 266-6481
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 085-002507 Illinois
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 085-002507 Illinois

Profile Details

NPI number 1396776498
LBN Legal business name Blackburn, Tracee A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2006
Last updated Dec 22nd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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