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General NPI Number Information
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NPI Number | 1801605514
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Entity Type | Individual
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Provider Name | JOETTA LITTLE
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Gender | Female
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 7601 S KOSTNER AVE STE 400
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City | CHICAGO
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State | IL
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Zip | 60652-1120
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Country | US
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Telephone | 217-284-2608
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Fax | 217-439-3547
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Provider Business Mailing Address
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Address Line | 2111 S WABASH AVE APT 2209
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City | CHICAGO
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State | IL
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Zip | 60616-1794
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Country | US
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Telephone | 217-552-0660
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD1100X
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Taxonomy Name | Peritoneal Dialysis Registered Nurse
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License Number | 041347586
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209.032795
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License Number State | IL
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