Healthcare Provider Details

I. General information

NPI: 1578420154
Provider Name (Legal Business Name): ADVANCE WOUND CARE MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S RANDALL RD
ELGIN IL
60123-4106
US

IV. Provider business mailing address

1001 S RANDALL RD
ELGIN IL
60123-4106
US

V. Phone/Fax

Practice location:
  • Phone: 847-890-0656
  • Fax: 847-214-3634
Mailing address:
  • Phone: 847-890-0656
  • Fax: 847-214-3634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RAMON PACHECO
Title or Position: OWNER
Credential:
Phone: 847-890-0656