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General NPI Number Information
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NPI Number | 1417619172
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Entity Type | Individual
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Provider Name | TRACEY ROONEY APRN-CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/11/2021
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 225 EAST CHICAGO AVENUE DEPARTMENT OF ANESTHESIA
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City | CHICAGO
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State | IL
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Zip | 60611-2605
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Country | US
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Telephone | 312-227-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 4227 N LAWNDALE AVE
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City | CHICAGO
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State | IL
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Zip | 60618-2008
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Country | US
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Telephone | 608-669-0022
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209.024159
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License Number State | IL
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