Provider Demographics
NPI:1750171807
Name:MILES OF CARE DIVISIONS
Entity type:Organization
Organization Name:MILES OF CARE DIVISIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REP
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:773-960-1202
Mailing Address - Street 1:PO BOX 19111
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-0002
Mailing Address - Country:US
Mailing Address - Phone:773-960-1202
Mailing Address - Fax:708-933-3459
Practice Address - Street 1:10408 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2508
Practice Address - Country:US
Practice Address - Phone:773-960-1202
Practice Address - Fax:708-933-3459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy