Traci Melinda Fertel

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-001920 Issued in IL

Practice address

13300 Division
Suite B7
Plainfield, IL 60585

Phone

(815) 577-3666

NPI assigned

Dec 29, 2006

Last updated

May 17, 2010By 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 2

Addresses

Other names 1

• Ms. Traci Melinda Fertel Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1902962178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 W SUMMERDALE AVE",
            "address_2": "#3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402127",
            "telephone_number": "773-271-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 DIVISION",
            "address_2": "SUITE B7",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "60585",
            "telephone_number": "815-577-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERTEL",
        "first_name": "TRACI",
        "middle_name": "MELINDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-001920",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "149-001920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "FERTEL",
            "middle_name": "MELINDA",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gayle Lynne Farmer
• Jillian Febel
• Patricia Ann Ferdon
• Michael Patrick Fergus, DC, DACBR
• Katrina Ferracane, PMHNP
• Amanda Jane Ficht, M.S. OTR
• Diana Lili Figueroa
• Alyssa Fijalkowski
• Joshua David Fink, PA-C
• Kathleen Finnegan, M.T.

• Clinical Social Worker in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.