Provider Demographics
NPI:1174096390
Name:BRITT, LEMIA
Entity type:Individual
Prefix:
First Name:LEMIA
Middle Name:
Last Name:BRITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-1267
Mailing Address - Country:US
Mailing Address - Phone:773-595-1116
Mailing Address - Fax:
Practice Address - Street 1:650 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-1267
Practice Address - Country:US
Practice Address - Phone:773-595-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies