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General NPI Number Information
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NPI Number | 1013726058
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Entity Type | Organization
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Legal Business Name | SIMPLY WOUNDS ADVANCED WOUND CARE
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 11638 S PULASKI RD STE B
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City | ALSIP
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State | IL
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Zip | 60803-1622
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Country | US
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Telephone | 773-484-6042
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Fax | 534-429-4415
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Provider Business Mailing Address
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Address Line | 9915 W 143RD ST
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City | ORLAND PARK
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State | IL
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Zip | 60462-2007
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Country | US
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Telephone | 773-484-6042
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Fax | 534-429-4415
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Authorized Official
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Title or Position | OWNER
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Name | MRS. IESHA NWAGWU
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Credential | NURSE PRACTITIONER
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Telephone | 773-484-6042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State | NULL
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