Healthcare Provider Details

I. General information

NPI: 1043342223
Provider Name (Legal Business Name): WOUNDCARE ON WHEELS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 03/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 S WASHINGTON ST STE 101
NAPERVILLE IL
60540-6663
US

IV. Provider business mailing address

608 S WASHINGTON ST STE 101
NAPERVILLE IL
60540-6663
US

V. Phone/Fax

Practice location:
  • Phone: 630-898-3360
  • Fax: 630-898-3358
Mailing address:
  • Phone: 630-898-3360
  • Fax: 630-898-3358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY FOOTE
Title or Position: OWNER
Credential: CCNS
Phone: 630-898-3360