Provider Demographics
NPI:1164279709
Name:MAI, TRACY YAN (MS, SLP/L)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:YAN
Last Name:MAI
Suffix:
Gender:F
Credentials:MS, SLP/L
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:YAN
Other - Last Name:MAI-LAUFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:434 SIGNAL HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2247
Mailing Address - Country:US
Mailing Address - Phone:773-627-2889
Mailing Address - Fax:
Practice Address - Street 1:434 SIGNAL HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2247
Practice Address - Country:US
Practice Address - Phone:773-627-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist