Healthcare Provider Details

I. General information

NPI: 1619635216
Provider Name (Legal Business Name): BRITTANY MALABANAN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY HOFFMAN

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BIESTERFIELD RD STE 310
ELK GROVE VILLAGE IL
60007-7324
US

IV. Provider business mailing address

120 W 22ND ST STE 200
OAK BROOK IL
60523-1563
US

V. Phone/Fax

Practice location:
  • Phone: 847-952-9332
  • Fax: 847-952-9338
Mailing address:
  • Phone: 630-573-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209024597
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041444526
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: