Stephanie Tracey, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-001077 Issued in IL

Practice address

550 E Devon Ave Ste 200
Itasca, IL 60143-2639

Phone

(864) 625-3376

NPI assigned

Oct 12, 2006

Last updated

Mar 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Dermatology LLCGroup PAC ID 7810256849, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oak Dermatology LLC

  • MOHS-Micrographic Surgery Physician
  • Itasca, IL
  • NPI 1487168258
  Medicare reassignment Care Compare group
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Central Dupage Emergency Physicians, PC

  • Emergency Medicine Physician
  • Winfield, IL
  • NPI 1619074028
  Medicare reassignment
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Medicare reassignment
• Paul Getz, M.D., S.C.

  dba Dundee Dermatology

  • Specialist
  • West Dundee, IL
  • NPI 1740302165
  Medicare reassignment
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  NPD
• Edward Health Ventures

  dba Edward Medical Group

  • Family Medicine Physician
  • Plainfield, IL
  • NPI 1851636047
  NPD
• Winfield Pathology Consultants, S.C.

  • Anatomic Pathology Physician
  • Winfield, IL
  • NPI 1528147071
  NPD
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1275622888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E DEVON AVE STE 200",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432639",
            "telephone_number": "864-625-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E DEVON AVE STE 200",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432639",
            "telephone_number": "864-625-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Stevens
• Mira Suvagia, DMD, MS
• Caitlin Tacadena, BCBA
• Mohammad Tauseef
• Terrence Tom, BCBA
• Genesis Trujillo
• Ukoha Joas Pediatric Dentistry, P.C
• Kalin Upson
• Kaylie Vaden
• Nancy Varghese

• Physician Assistant in Itasca, IL
• Providers in Itasca, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.