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General NPI Number Information
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NPI Number | 1497460489
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Entity Type | Organization
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Legal Business Name | ARCHOS WOUND SPECIALISTS INC
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 2720 S RIVER RD STE 4
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City | DES PLAINES
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State | IL
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Zip | 60018-4109
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Country | US
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Telephone | 708-305-6086
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Fax |
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Provider Business Mailing Address
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Address Line | 1328 MAIN ST
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City | CRETE
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State | IL
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Zip | 60417-2131
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Country | US
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Telephone | 847-800-0957
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Fax | 847-972-1863
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MISS VANESSA ADRANEDA
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Credential | RN
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Telephone | 847-800-0957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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