Organization
LITTLE COMPANY OF MARY AFFILIATED SERVICES INC
Active
Other names
LITTLE CO OF MARY CARE STATION
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A HEENAN (DIRECTOR, PROFESSIONAL SERVICES)
(708) 229-5171
Entity
Organization
Contact information
Practice address
5660 W 95TH ST, SUITE 1, OAK LAWN, IL 60453-2380
(708) 499-2273
(708) 857-4435
Mailing address
5660 W 95TH ST, SUITE 1, OAK LAWN, IL 60453-2380
(708) 499-2273
(708) 857-4435
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617116
BC/BS PROVIDER NUMBER
IL
01
—
2420962
UNITED HEALTH CARE MPIN
IL
Enumeration date
05/19/2006
Last updated
03/11/2010
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