Provider Demographics
NPI:1730529603
Name:CALDWELL, BRITTANY NICOLE (DC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 N CITYFRONT PLAZA DR STE 2040
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5318
Mailing Address - Country:US
Mailing Address - Phone:312-600-6128
Mailing Address - Fax:
Practice Address - Street 1:455 N CITYFRONT PLZ DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5503
Practice Address - Country:US
Practice Address - Phone:312-600-6128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor