Provider Demographics
NPI:1265670913
Name:BRITANICO, ANNA PAMELA (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:PAMELA
Last Name:BRITANICO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:PAMELA
Other - Last Name:CANLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9933 LAWLER AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3753
Mailing Address - Country:US
Mailing Address - Phone:262-344-2430
Mailing Address - Fax:
Practice Address - Street 1:9933 LAWLER AVE STE 105
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3753
Practice Address - Country:US
Practice Address - Phone:847-786-0213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
IL070015215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070015215OtherPRIVATE INSURANCES