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General NPI Number Information
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NPI Number | 1972394393
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Entity Type | Organization
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Legal Business Name | MOMMY & ME HEALTH TEAM
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 21315 TOWER AVE
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City | MATTESON
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State | IL
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Zip | 60443-2453
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Country | US
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Telephone | 630-460-8213
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Fax |
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Provider Business Mailing Address
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Address Line | 21315 TOWER AVE
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City | MATTESON
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State | IL
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Zip | 60443-2453
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Country | US
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Telephone | 630-460-8213
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LENITA DESHOUN MILLER
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Credential | CNA
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Telephone | 630-460-8213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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