Organization
LIL'S LOW CARB INC
Active
Other names
Lil's Dietary Specialty Shop
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIE HARVEY (PRESIDENT)
(773) 239-0355
Entity
Organization
Contact information
Practice address
2738 W 111TH ST, CHICAGO, IL 60655-1832
(773) 239-0355
Mailing address
2738 W 111TH ST, CHICAGO, IL 60655-1832
(773) 239-0355
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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