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General NPI Number Information
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NPI Number | 1255120150
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Entity Type | Organization
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Legal Business Name | USP CLINICAL GPS PLLC
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 6446 W 127TH ST
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-2248
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Country | US
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Telephone | 708-448-7588
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Fax |
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Provider Business Mailing Address
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Address Line | 6446 W 127TH ST
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-2248
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Country | US
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Telephone | 708-448-7588
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM LITTLE
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Credential |
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Telephone | 708-448-7588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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