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General NPI Number Information
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NPI Number | 1851524318
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Entity Type | Individual
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Provider Name | JUAN I BRITO O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 5005 NORTHWEST HWY
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-7324
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Country | US
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Telephone | 815-479-0177
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Fax | 262-923-7673
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Provider Business Mailing Address
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Address Line | 16800 W CLEVELAND AVE
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City | NEW BERLIN
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State | WI
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Zip | 53151-3533
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Country | US
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Telephone | 262-432-2005
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Fax | 262-432-2006
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3547
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046010282
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License Number State | IL
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