Healthcare Provider Details

I. General information

NPI: 1184413379
Provider Name (Legal Business Name): ACCELERATED WOUND CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 S RIVER RD STE 256
DES PLAINES IL
60018-4111
US

IV. Provider business mailing address

2720 S RIVER RD STE 256
DES PLAINES IL
60018-4111
US

V. Phone/Fax

Practice location:
  • Phone: 844-292-5708
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: GURIQBAL NANDRA
Title or Position: MANAGER
Credential:
Phone: 844-292-5708