Provider Demographics
NPI:1508677964
Name:INTEGRATED WOUND CONSULTANTS LLC
Entity type:Organization
Organization Name:INTEGRATED WOUND CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-873-9215
Mailing Address - Street 1:1919 S HIGHLAND AVE STE 300B
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4979
Mailing Address - Country:US
Mailing Address - Phone:630-413-9119
Mailing Address - Fax:
Practice Address - Street 1:1919 S HIGHLAND AVE STE 300B
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4979
Practice Address - Country:US
Practice Address - Phone:630-413-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty