NPIMap

Organization Active NPI

Dr. Tracey Kinigakis,M.D.- Your Wellness Partner,LLC

  • Primary Care Clinic/Center
  • Rockford, IL
National Provider Identifier
1225279680
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036-095213 Issued in IL
Legal business name
DR. TRACEY KINIGAKIS,M.D.- YOUR WELLNESS PARTNER,LLC
Practice address
1495 Northrock CT
Rockford, IL 61103-1233
Phone
(815) 618-8116
NPI assigned
Mar 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tracey Dawn Kinigakis, M.D.
Title
Proprietor
Phone
(815) 618-8116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036-095213 IL Primary

Addresses

Primary practice location

1495 Northrock CT
Rockford, IL 61103-1233

Mailing address

1495 Northrock CT
Rockford, IL 61103-1233
Phone (815) 618-8116

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1225279680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 NORTHROCK CT",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611031233",
            "telephone_number": "815-618-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 NORTHROCK CT",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611031233",
            "telephone_number": "815-618-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. TRACEY KINIGAKIS,M.D.- YOUR WELLNESS PARTNER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "KINIGAKIS",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "815-618-8116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036-095213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.