Basic Information
| Provider Information | |||||||||
| NPI: | 1740619394 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMILLO | ||||||||
| FirstName: | BRITTANY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3213 N ROCKWELL ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606185934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474529659 | ||||||||
| FaxNumber: | 7733038297 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 S MICHIGAN AVE | ||||||||
| Address2: | STE 2212 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606033357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3123461136 | ||||||||
| FaxNumber: | 3128532293 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2013 | ||||||||
| LastUpdateDate: | 04/28/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.