=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215892674
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORION WOUND CARE OF IL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2025
-----------------------------------------------------
Last Update Date | 12/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5836 LINCOLN AVE STE 200
-----------------------------------------------------
City | MORTON GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60053-3326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-300-9833
-----------------------------------------------------
Fax | 847-628-2447
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5836 LINCOLN AVE STE 200
-----------------------------------------------------
City | MORTON GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60053-3326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-300-9833
-----------------------------------------------------
Fax | 847-628-2447
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SYED WARSI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 773-300-9833
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------