Individual provider Active NPI

Brittany Sullivan, D. C.

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1629311261
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012379 Issued in IL
Practice address
6833 Stalter Dr Ste 203
Rockford, IL 61108-2582
Phone
(815) 904-6650
Fax
(815) 904-6564
NPI assigned
Apr 2, 2013
Last updated
Jun 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012379 IL Primary

Addresses

Primary practice location

6833 Stalter Dr Ste 203
Rockford, IL 61108-2582

Mailing address

5588 Forest Trail Dr
Rockford, IL 61109-6534
Phone (815) 988-7831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331003934 IL Practitioner - Chiropractic 7012492648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5588 Forest Trail Dr
Rockford, IL 61109-6534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012379ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Spine & Wellness Center, Inc CurrentSince Oct 1, 2020 Accepting new patients

Locations

6833 Stalter Dr
Ste 203
Rockford, IL 61108
Phone (815) 904-6650

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1629311261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5588 FOREST TRAIL DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611096534",
            "telephone_number": "815-988-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6833 STALTER DR STE 203",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082582",
            "telephone_number": "815-904-6650",
            "fax_number": "815-904-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRITTANY",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.