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General NPI Number Information
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NPI Number | 1003739145
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Entity Type | Individual
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Provider Name | TRACY LAVONNE LEE R-DMT
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Gender | Female
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 8 S MICHIGAN AVE STE 2500
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City | CHICAGO
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State | IL
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Zip | 60603-3329
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Country | US
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Telephone | 312-283-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 7033 N KEDZIE AVE APT 1711
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City | CHICAGO
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State | IL
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Zip | 60645-2854
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Country | US
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Telephone | 774-837-3677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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