Fuller, Tracy C

Fuller, Tracy C is an individual health care provider with primary practice located at 2650 Ridge Ave Emergency Department: Physician Assistants, Evanston IL 60201-1718. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Fuller, Tracy C can be contacted via phone (847) 570-1353.

Contact Information

Primary practice address
2650 Ridge Ave Emergency Department: Physician Assistants Evanston IL 60201-1718
Phone: (847) 570-1353
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.004406 Illinois

Profile Details

NPI number 1386994408
LBN Legal business name Fuller, Tracy C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2012
Last updated Mar 23rd, 2018 - about 8 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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