MEDICARE: TRACI D CONEY, LLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1750155537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRACI D CONEY, LLC

Provider Business Mailing Address
First Line	:	11100 S BELL AVE APT 100-2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3909
Country	:	US
Telephone Number	:	773-517-8269
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 S BELL AVE APT 100-2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3909
Country	:	US
Telephone Number	:	773-517-8269
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	MS. TRACI DONIELLE CONEY
Credential	:	LCSW
Telephone Number	:	773-255-5636

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	02/17/2026

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