Provider Demographics
NPI:1407962129
Name:LITTIG, TRICIA A (APN, CNP)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:A
Last Name:LITTIG
Suffix:
Gender:F
Credentials:APN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 22ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1563
Mailing Address - Country:US
Mailing Address - Phone:630-573-5000
Mailing Address - Fax:
Practice Address - Street 1:2340 S HIGHLAND AVE STE 160
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5395
Practice Address - Country:US
Practice Address - Phone:630-495-9356
Practice Address - Fax:630-495-3770
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005843363LA2200X
IL277.000303363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q65208Medicare UPIN
ILK25979Medicare PIN
P00366444Medicare PIN