Healthcare Provider Details

I. General information

NPI: 1114725603
Provider Name (Legal Business Name): MRS. TRACEY FREMPONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACEY KYEI

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 MEADOW CREEK DR
WESTMINSTER MD
21158-9426
US

IV. Provider business mailing address

750 N COMMONS DR STE 200
AURORA IL
60504-8025
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-1200
  • Fax: 410-848-4916
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01702
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: