Healthcare Provider Details

I. General information

NPI: 1811394042
Provider Name (Legal Business Name): BRITANI PAIGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 US HIGHWAY 41 STE A20
SCHERERVILLE IN
46375-1394
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 219-322-5560
  • Fax:
Mailing address:
  • Phone: 219-322-5560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05011686A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: