Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2023-04-28
- Last updated
- 2025-09-08
Licenses
The registry row did not include a license.
Location
- Practice location
- 3533 FAIRWAY CT
- City
- CRETE IL
- Postal code
- 604171048
- Phone
- 773-960-1202
Organization contact
- Name
- TAMMISHIA LITTLE
- Title
- Owner
- Phone
- 7739601202
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.