Healthcare Provider Details

I. General information

NPI: 1205416062
Provider Name (Legal Business Name): A LITTLE ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7716 S CREGIER AVE
CHICAGO IL
60649
US

IV. Provider business mailing address

7716 S CREGIER AVE
CHICAGO IL
60649-4610
US

V. Phone/Fax

Practice location:
  • Phone: 773-960-1202
  • Fax:
Mailing address:
  • Phone: 773-960-1202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMMISHIA LITTLE
Title or Position: NURSE DIRECTOR
Credential:
Phone: 773-960-1202