Organization
MOBILE WOUNDCARE CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN ANN MACK NP (PRESIDENT)
(847) 337-1397
Entity
Organization
Contact information
Practice address
514 TEELA LN, DES PLAINES, IL 60016-1230
(847) 337-1397
(866) 840-2110
Mailing address
PO BOX 405, MT PROSPECT, IL 60056-0405
(847) 337-1397
(866) 840-2110
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326644911001
—
IL
05
—
332520251001
—
IL
Enumeration date
08/16/2005
Last updated
08/22/2020
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