Provider Demographics
NPI:1386104982
Name:CHAPMAN, BRITTNI KRISTINE
Entity type:Individual
Prefix:
First Name:BRITTNI
Middle Name:KRISTINE
Last Name:CHAPMAN
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 1:724 ALADAR DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7511
Mailing Address - Country:US
Mailing Address - Phone:618-972-2026
Mailing Address - Fax:
Practice Address - Street 1:4 157 CTR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3657
Practice Address - Country:US
Practice Address - Phone:618-692-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.13342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038.013342OtherLICENSE NUMBER