Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tracy Scott Hickam

Individual provider Occupational Therapist · NPI 1891654349

Tracy Scott Hickam is an Occupational Therapist in Private Practice in Edwardsville, Illinois. Qualified in 1980, 46 years ago. Practices as a sole proprietor.

Years since qualifying
46
In the registry since
2026

Practice location Address checks out

3210 Staunton Rd
Edwardsville, IL 62025-6926
Phone: (559) 563-5760
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 056005745

Record details

NPI number1891654349
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 20, 2026
Last updated in NPPESJanuary 21, 2026
Certification dateJanuary 21, 2026
Mailing address3210 Staunton Rd, Edwardsville, IL 62025-6926

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1980 (46 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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