Healthcare Provider Details

I. General information

NPI: 1194642918
Provider Name (Legal Business Name): AVANT WOUND CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5962 N LINCOLN AVE UNIT 4
CHICAGO IL
60659-3711
US

IV. Provider business mailing address

5962 N LINCOLN AVE UNIT 4
CHICAGO IL
60659-3711
US

V. Phone/Fax

Practice location:
  • Phone: 702-969-8694
  • Fax: 702-996-8823
Mailing address:
  • Phone: 702-969-8694
  • Fax: 702-996-8823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID APOLINARIO
Title or Position: OWNER
Credential: NP
Phone: 702-969-6825