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Organization
WOUNDCARE AT HOME
Active
Organization
WOUNDCARE AT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN A MACK APN (PRESIDENT)
(847) 337-1396
Entity
Organization
Contact information
Practice address
514 TEELA LN, DES PLAINES, IL 60016-1230
(847) 337-1396
(888) 845-9162
Mailing address
514 TEELA LN, DES PLAINES, IL 60016-1230
(847) 337-1396
(888) 845-9162
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
060008633
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332520251001
—
IL
Enumeration date
06/04/2006
Last updated
09/18/2008
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