Provider Demographics
NPI:1407379324
Name:CYRIAC, LITTY (NP-C)
Entity Type:Individual
Prefix:
First Name:LITTY
Middle Name:
Last Name:CYRIAC
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12909 TIPPERARY LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2799
Mailing Address - Country:US
Mailing Address - Phone:630-915-6373
Mailing Address - Fax:
Practice Address - Street 1:13550 S ROUTE 30 STE 100
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5686
Practice Address - Country:US
Practice Address - Phone:630-915-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily