Provider Demographics
NPI:1124711239
Name:SMITH, BRITTANY ANN
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANN
Other - Last Name:GREIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:470 COUNTRY PL
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-4916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18160 W GAGES LAKE RD
Practice Address - Street 2:
Practice Address - City:GAGES LAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1819
Practice Address - Country:US
Practice Address - Phone:630-913-1189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist