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Organization
LITTLE COMPANY OF MARY AFFILIATED SERVICES INC
Active
Organization
LITTLE COMPANY OF MARY AFFILIATED SERVICES INC
Active
Other names
LITTLE CO OF MARY AFFILIATED
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A HEENAN (DIRECTOR PROFESSIONAL SERVICES)
(708) 229-5171
Entity
Organization
Contact information
Practice address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2701
(708) 229-5171
(708) 229-4209
Mailing address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2701
(708) 229-5171
(708) 229-4209
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/17/2006
Last updated
02/22/2010
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