MEDICARE: TRACY HEILERS LMT

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
1	225700000X	Massage Therapist	227023620	IL

General Provider Information

NPI Number	:	1568294502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY HEILERS LMT

Provider Business Mailing Address
First Line	:	523 MONROE AVE
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-3040
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 N 11TH AVE
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-2289
Country	:	US
Telephone Number	:	630-337-7452
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	03/12/2026

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