Basic Information
Provider Information
NPI: 1902303662
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMBO
FirstName: BRITTANY
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2650 RIDGE AVE STE 1223
Address2:  
City: EVANSTON
State: IL
PostalCode: 602011700
CountryCode: US
TelephoneNumber: 8479826715
FaxNumber:  
Practice Location
Address1: 5145 N CALIFORNIA AVE STE 331
Address2:  
City: CHICAGO
State: IL
PostalCode: 606253661
CountryCode: US
TelephoneNumber: 7739893808
FaxNumber: 7739891734
Other Information
ProviderEnumerationDate: 04/10/2018
LastUpdateDate: 06/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X036157312ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X036157312ILY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home