Healthcare Provider Details

I. General information

NPI: 1699582452
Provider Name (Legal Business Name): VULNERA MEDICUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 HANDEL CT
WHEATON IL
60189-2055
US

IV. Provider business mailing address

442 HANDEL CT
WHEATON IL
60189-2055
US

V. Phone/Fax

Practice location:
  • Phone: 815-341-2084
  • Fax:
Mailing address:
  • Phone: 815-341-2084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NEIL R FRIED
Title or Position: PODIATRIST
Credential: DPM
Phone: 815-341-2084