Organization
MILES OF CARE INFUSION & WELLNESS DIVISON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMISHIA LITTLE NURSE (AUTHORIZED REP)
(773) 960-1202
Entity
Organization
Contact information
Practice address
10408 S WESTERN AVE STE A, CHICAGO, IL 60643-2508
(773) 960-1202
(708) 933-3459
Mailing address
PO BOX 19111, CHICAGO, IL 60619-0002
(773) 960-1202
(708) 933-3459
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
261Q00000X
Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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