Provider Demographics
NPI:1992246094
Name:DUDA, BRITTANY (ATC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:DUDA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 PURCELL ST
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-8315
Mailing Address - Country:US
Mailing Address - Phone:630-421-1020
Mailing Address - Fax:
Practice Address - Street 1:963 N 129TH INFANTRY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-3104
Practice Address - Country:US
Practice Address - Phone:815-741-6900
Practice Address - Fax:815-741-6907
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer