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General NPI Number Information
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NPI Number | 1750171807
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Entity Type | Organization
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Legal Business Name | MILES OF CARE DIVISIONS
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 10408 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-2508
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Country | US
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Telephone | 773-960-1202
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Fax | 708-933-3459
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Provider Business Mailing Address
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Address Line | PO BOX 19111
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City | CHICAGO
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State | IL
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Zip | 60619-0002
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Country | US
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Telephone | 773-960-1202
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Fax | 708-933-3459
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Authorized Official
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Title or Position | AUTHORIZED REP
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Name | TAMMY LITTLE
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Credential | NURSE
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Telephone | 773-960-1202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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