Provider Demographics
NPI:1912355173
Name:BRITT, JENNIFER (PARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:BRITT
Suffix:
Gender:F
Credentials:PARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16625 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-6631
Mailing Address - Country:US
Mailing Address - Phone:815-834-9910
Mailing Address - Fax:815-834-9924
Practice Address - Street 1:16625 W 159TH ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-6631
Practice Address - Country:US
Practice Address - Phone:815-834-9910
Practice Address - Fax:815-834-9924
Is Sole Proprietor?:No
Enumeration Date:2016-05-28
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist