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General NPI Number Information
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NPI Number | 1922968478
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Entity Type | Organization
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Legal Business Name | WOUND RX MOBILE LLC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 4701 N CUMBERLAND AVE STE 10B SUITE 10B
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City | NORRIDGE
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State | IL
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Zip | 60706-4277
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Country | US
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Telephone | 630-670-8320
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Fax | 708-452-7990
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Provider Business Mailing Address
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Address Line | 4701 N CUMBERLAND AVE STE 10B
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City | NORRIDGE
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State | IL
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Zip | 60706-4277
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Country | US
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Telephone | 630-670-8320
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Fax | 708-452-7990
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. VANESSA R JACKSON
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Credential |
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Telephone | 630-670-8320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 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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