Brittany Mitacek, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096002960 Issued in IL

Practice address

18500 Burnham Ave
Lansing, IL 60438-3046

Phone

(708) 585-9725

NPI assigned

Mar 4, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1679998371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8629 MANOR AVE APT D",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18500 BURNHAM AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604383046",
            "telephone_number": "708-585-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITACEK",
        "first_name": "BRITTANY",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Meggs, MD
• Jocelin Nicole Mendez
• Jennifer Meyer, MA
• Cynthia Lynette Michel
• Melinda Miller, BCBA
• Molenaar Eyecare Specialists LTD
• Brant Tregellas Molenaar, OD
• Gordon Wesley Molenaar, OD
• Matthew Molenaar, LCSW
• Momentum Behavior Services LLC

• Athletic Trainer in Lansing, IL
• Providers in Lansing, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.