Healthcare Provider Details

I. General information

NPI: 1083133706
Provider Name (Legal Business Name): BRITTANY M CONRAD NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SPALDING DR STE 406
NAPERVILLE IL
60540-6554
US

IV. Provider business mailing address

1860 PAYSHERE CIRCLE
CHICAGO IL
60674
US

V. Phone/Fax

Practice location:
  • Phone: 630-961-9485
  • Fax:
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.016455
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: