Healthcare Provider Details

I. General information

NPI: 1982560132
Provider Name (Legal Business Name): MS. LAJOY PATRICE PITTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE
CHICAGO IL
60637-1443
US

IV. Provider business mailing address

14433 S BENSLEY AVE
CHICAGO IL
60633-2203
US

V. Phone/Fax

Practice location:
  • Phone: 888-824-0200
  • Fax:
Mailing address:
  • Phone: 708-870-9317
  • Fax: 708-870-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209033679
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: