Healthcare Provider Details

I. General information

NPI: 1497665293
Provider Name (Legal Business Name): DR. BRITTANY MICHELLE BEDFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E MAIN ST
DANVILLE IL
61832-5100
US

IV. Provider business mailing address

4505 LEGENDS DR APT 301
CHAMPAIGN IL
61822-1536
US

V. Phone/Fax

Practice location:
  • Phone: 217-554-3000
  • Fax:
Mailing address:
  • Phone: 630-383-1195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419192
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: