Healthcare Provider Details

I. General information

NPI: 1437890225
Provider Name (Legal Business Name): BRITTANY WELCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 75TH ST
WILLOWBROOK IL
60527-2325
US

IV. Provider business mailing address

302 W VERMONT AVE
URBANA IL
61801-4927
US

V. Phone/Fax

Practice location:
  • Phone: 630-581-5372
  • Fax:
Mailing address:
  • Phone: 217-840-5117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.430238
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209026784
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209026784
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: