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NPI Code Detail

MEDICARE: TRACY LAUBENSTEIN

MEDICARE: TRACY LAUBENSTEIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner6612-33WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588031934
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY LAUBENSTEIN
Provider Business Mailing Address
First Line : 5454 FARGO AVE
Second Line :
City : SKOKIE
State : IL
Zip : 60077-3210
Country : US
Telephone Number : 414-208-6933
Fax Number :
Provider Business Practice Location Address
First Line : 18740 W BLUEMOUND RD
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-2936
Country : US
Telephone Number : 414-208-6933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2015
Last Update Date : 12/02/2025

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