Provider Demographics
NPI:1023864808
Name:ADVANCED WOUND CARE ASSOCIATES PLLC
Entity type:Organization
Organization Name:ADVANCED WOUND CARE ASSOCIATES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALZEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-424-7600
Mailing Address - Street 1:5540 W 111TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-5575
Mailing Address - Country:US
Mailing Address - Phone:708-424-7600
Mailing Address - Fax:708-424-7605
Practice Address - Street 1:5540 W 111TH ST STE 2
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-5575
Practice Address - Country:US
Practice Address - Phone:708-424-7600
Practice Address - Fax:708-424-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty