Healthcare Provider Details

I. General information

NPI: 1427968775
Provider Name (Legal Business Name): BRITTANY NICOLE DAZZO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 S RANDALL RD
ELGIN IL
60123-5526
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 847-930-5950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.040725
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: