MEDICARE: DR. ANNA MARIE LITTLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036129821	IL
2	208000000X	Pediatrics Physician	036129821	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CF3444	OTHER	IL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982801742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA MARIE LITTLE MD

Provider Business Mailing Address
First Line	:	109 CALIFORNIA ST
Second Line	:	PO BOX 577
City	:	CARTERVILLE
State	:	IL
Zip	:	62918-0577
Country	:	US
Telephone Number	:	618-985-8221
Fax Number	:	618-985-6860

Provider Business Practice Location Address
First Line	:	400 S LEWIS LN
Second Line	:
City	:	CARBONDALE
State	:	IL
Zip	:	62901-3547
Country	:	US
Telephone Number	:	618-519-9900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	12/11/2020

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