| Advanced Woundcare, Inc | |
|
5250 Old Orchard Rd Ste 300 Skokie IL 60077-4462 | |
| (224) 935-9522 | |
| (224) 935-4399 |
| Full Name | Advanced Woundcare, Inc |
|---|---|
| Speciality | General Practice |
| Location | 5250 Old Orchard Rd Ste 300, Skokie, Illinois |
| Authorized Official Name and Position | Liela Maatouk (ADMINISTRATOR) |
| Authorized Official Contact | 8477307098 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Woundcare, Inc 5250 Old Orchard Rd Ste 300 Skokie IL 60077-4462 Ph: (224) 935-9522 | Advanced Woundcare, Inc 5250 Old Orchard Rd Ste 300 Skokie IL 60077-4462 Ph: (224) 935-9522 |
| NPI Number | 1447821459 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 10/06/2023 |
| Medicare PECOS PAC ID | 3678971389 |
|---|---|
| Medicare Enrollment ID | O20211011002662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447821459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Zivojin S Pavlovic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669454658 PECOS PAC ID: 7810980240 Enrollment ID: I20040403000044 |
| Provider Name | Roger A Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184037319 PECOS PAC ID: 0042267312 Enrollment ID: I20050407001246 |
| Provider Name | Mark B Lubienski |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1376543025 PECOS PAC ID: 3375445877 Enrollment ID: I20050512000747 |
| Provider Name | Issam M Maatouk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013051705 PECOS PAC ID: 6103981063 Enrollment ID: I20090210000591 |
| Provider Name | Michal A Piszczuk |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1679737100 PECOS PAC ID: 6204090780 Enrollment ID: I20120613000291 |
| Provider Name | Jelena Markovic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013263219 PECOS PAC ID: 1951617083 Enrollment ID: I20171107001914 |
| Provider Name | Mieka Patrice Shuman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982198537 PECOS PAC ID: 0648527580 Enrollment ID: I20210414000533 |
| Provider Name | Sara Stasior |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518676790 PECOS PAC ID: 7517305865 Enrollment ID: I20240404003365 |
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