=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699574392
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABOVE AND BEYOND WOUND CARE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2025
-----------------------------------------------------
Last Update Date | 07/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 636 S RIVER RD STE 304
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60016-4624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-214-4232
-----------------------------------------------------
Fax | 224-537-0020
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 636 S RIVER RD STE 304
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60016-4624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-214-4232
-----------------------------------------------------
Fax | 224-537-0020
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JAMIE CADET
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 224-214-4232
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------