Healthcare Provider Details

I. General information

NPI: 1023864808
Provider Name (Legal Business Name): ADVANCED WOUND CARE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 N RIVER RD STE 800
ROSEMONT IL
60018-5166
US

IV. Provider business mailing address

5600 N RIVER RD STE 800
ROSEMONT IL
60018-5166
US

V. Phone/Fax

Practice location:
  • Phone: 708-433-2000
  • Fax: 708-433-2001
Mailing address:
  • Phone: 708-433-2000
  • Fax: 708-433-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIEV HUYNH
Title or Position: OWNER
Credential: APRN-FPA
Phone: 773-780-9297