Healthcare Provider Details
I. General information
NPI: 1457235061
Provider Name (Legal Business Name): TWIN VILLAGE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
680 N LAKE SHORE DR STE 1103085
CHICAGO IL
60611-4546
US
IV. Provider business mailing address
8499 DUNGARVAN RD
FRANKFORT IL
60423-9358
US
V. Phone/Fax
- Phone: 872-266-6390
- Fax: 872-266-6391
- Phone: 708-298-2614
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 202D00000X |
| Taxonomy | Integrative Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRITTANI
JAMES
Title or Position: OWNER
Credential: MD
Phone: 708-298-2614