MEDICARE: LITTLE FRIENDS

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	222Q00000X	Developmental Therapist	LS98770806P	IL

General Provider Information

NPI Number	:	1962626176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE FRIENDS

Provider Business Mailing Address
First Line	:	1001 E. CHICAGO AVE.
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-5526
Country	:	US
Telephone Number	:	630-355-6533
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 E CHICAGO AVE
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-5526
Country	:	US
Telephone Number	:	630-778-2613
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	KRISTI LANDORF
Credential	:
Telephone Number	:	630-355-6533

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	11/30/2015

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Directions to “LITTLE FRIENDS ” Practice Location

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