Healthcare Provider Details

I. General information

NPI: 1568192425
Provider Name (Legal Business Name): BRITTANY ELIZABETH BISAILLON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24600 W 127TH ST STE B340
PLAINFIELD IL
60585-9517
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 815-731-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149024223
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: