Tracey Dawn Kinigakis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036095213 Issued in IL

Practice address

1495 Northrock CT
Rockford, IL 61103-1233

Phone

(815) 618-8116

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Tracey Dawn Quart Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Osborne Wellness Center, SC

  • Clinic/Center
  • Rockford, IL
  • NPI 1932227931
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1952337131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10168 SUSAN CT",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610739309",
            "telephone_number": "815-623-1354"
        },
        {
            "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": {
        "last_name": "KINIGAKIS",
        "first_name": "TRACEY",
        "middle_name": "DAWN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036095213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "834340",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "834370",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "834330",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "553180",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "846930",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "QUART",
            "middle_name": "DAWN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Kindler, LCSW
• Jaime Lynne King, O.D.
• Julia CS King, MD
• Katelan Meredith King, PTA, CBIS
• Mitchell S King, MD
• Jonathan Edward Kinscherff, PHARMD
• Jacqueline Marie Kirchner, RDN
• Jonathan Robert Kirk, DC
• Jordin Marie Kirk
• Amy Kirsch, RN, MSN

• Family Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.