Healthcare Provider Details

I. General information

NPI: 1184176141
Provider Name (Legal Business Name): BRITTANY GEBBEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY REHM

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 W 63RD ST
WESTMONT IL
60559-2606
US

IV. Provider business mailing address

14951 AUSTIN DR
LOCKPORT IL
60441-1328
US

V. Phone/Fax

Practice location:
  • Phone: 630-852-9390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051297743
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: