Provider Demographics
NPI:1821895236
Name:WEST SUBURBAN WOUND CARE LLC
Entity type:Organization
Organization Name:WEST SUBURBAN WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:VENOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-567-5885
Mailing Address - Street 1:3030 WARRENVILLE RD STE 450-02
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3030 WARRENVILLE RD STE 450-02
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1000
Practice Address - Country:US
Practice Address - Phone:630-473-7963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty