Provider Demographics
NPI:1225621972
Name:WETZEL, BRITTANY M (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:M
Last Name:WETZEL
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W SUPERIOR ST APT 4804
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8865
Mailing Address - Country:US
Mailing Address - Phone:847-651-9692
Mailing Address - Fax:
Practice Address - Street 1:225 W HUBBARD ST STE 302
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-4916
Practice Address - Country:US
Practice Address - Phone:773-598-4387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001548171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist