# EC PHYSICIAN AND WOUND SPECIALIST LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689165490
- **Authorized official:** ELISABETH KERNS CORMIER MD (PHYSICIAN)
- **Authorized official phone:** (847) 998-0862

## Contact information

- **Practice address:** 1000 N WESTMORELAND RD, LAKE FOREST, IL 60045
- **Practice address phone:** (847) 535-7600
- **Mailing address:** 625 GLENDALE DR, GLENVIEW, IL 60025-4412
- **Mailing address phone:** (847) 998-0862

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036076935 | IL | Yes |

## Other

- **Enumeration date:** 05/29/2018
- **Last updated:** 08/14/2018