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Contact Information

TRACIE L SIPPLE, PT
312 E READER ST
ELBURN, IL60119
 Phone: 505-220-3401
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for TRACIE L SIPPLE · (Female)

NPI Number 1205836707
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 07/26/2005
Last updated 03/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 2646
  • NM Other 000Q0406 MEDICAID GROUP #
  • NM Other P00348972 RAILROAD MEDICARE
  • NM Other 2646 STATE OF NM REG & LICENS.
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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