Healthcare Provider Details

I. General information

NPI: 1033838891
Provider Name (Legal Business Name): LITTLE SPROUTS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6613 WESTMORELAND DR
WOODRIDGE IL
60517-1601
US

IV. Provider business mailing address

6613 WESTMORELAND DR
WOODRIDGE IL
60517-1601
US

V. Phone/Fax

Practice location:
  • Phone: 630-728-2413
  • Fax:
Mailing address:
  • Phone: 630-216-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY A COSSMANN
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 630-728-2413