MEDICARE: BIG LITTLE VICTORIES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1477375103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIG LITTLE VICTORIES LLC

Provider Business Mailing Address
First Line	:	3649 N MARSHFIELD AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3649 N MARSHFIELD AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6959
Country	:	US
Telephone Number	:	980-395-0867
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MOLLY HULBERT
Credential	:	MS, CCC-SLP
Telephone Number	:	980-395-0867

Provider Enumeration Date	:	10/24/2024
Last Update Date	:	01/21/2025

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Directions to “BIG LITTLE VICTORIES LLC ” Practice Location

Language	Start Address	Practice Location

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