Tracy Richardson, DPT,CCCE,CCI

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

070-016939 Issued in IL

Practice address

900 N 2ND St
Rochelle, IL 61068-1764

Phone

(815) 758-0000

Fax

(815) 748-3014

NPI assigned

Jun 26, 2012

Last updated

Nov 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1972867711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 ABERDEEN CT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783175",
            "telephone_number": "815-758-0000",
            "fax_number": "815-748-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 2ND ST",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610681764",
            "telephone_number": "815-758-0000",
            "fax_number": "815-748-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TRACY",
        "credential": "DPT,CCCE,CCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "070016939",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070-016939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Anderson Prunty, LCSW
• Marddi Jean Rahn, FNP
• Srinithya Ramachandran, NP-G
• Allison R Reed, DPT
• Residential Alternatives of Illinois, Inc (Manor Court of Rochelle)
• Craig Allan Ritchie
• Rochelle Community Hospital Association (Family Healthcare Clinic)
• Rochelle Community Hospital Association
• Rochelle Community Hospital Association
• Rochelle Community Hospital Association

• Orthopedic Physical Therapist in Rochelle, IL
• Providers in Rochelle, IL by specialty
• Orthopedic Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.