Provider Demographics
NPI:1194345280
Name:CLINE, BRITTANY J
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:J
Last Name:CLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 1315
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2923
Mailing Address - Country:US
Mailing Address - Phone:312-472-4683
Mailing Address - Fax:312-695-6888
Practice Address - Street 1:675 N SAINT CLAIR ST STE 14-200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5966
Practice Address - Country:US
Practice Address - Phone:312-695-7382
Practice Address - Fax:312-695-0014
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036163054207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program