Khoury, Tracie A
Khoury, Tracie A is an individual health care provider with primary practice located at 901 W Glen Ave Suite A, Peoria IL 61614-4836. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Khoury, Tracie A can be contacted via phone (309) 693-1212.Contact Information
Primary practice address
901 W Glen Ave Suite A
Peoria IL 61614-4836
Phone: (309) 693-1212
Fax: (309) 693-2147
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 038009705 | Illinois |
Profile Details
| NPI number | 1588639835 |
|---|---|
| LBN Legal business name | Khoury, Tracie A |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Jan 30th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588639835 | NPPES |
| Illinois | MEDICAID | 038009705 |
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