Healthcare Provider Details

I. General information

NPI: 1679480651
Provider Name (Legal Business Name): BRITTANY CARLBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W WASHINGTON AVE
EFFINGHAM IL
62401-2355
US

IV. Provider business mailing address

18262 N 1500TH ST
EFFINGHAM IL
62401-6988
US

V. Phone/Fax

Practice location:
  • Phone: 618-507-9163
  • Fax:
Mailing address:
  • Phone: 217-663-2125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198.012000
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: