NPIMap

Organization Active NPI

Illinois Wound Care Centers LLC

  • Wound Care Registered Nurse
  • Belvidere, IL
National Provider Identifier
1255912341
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
ILLINOIS WOUND CARE CENTERS LLC
Practice address
1424 N State St
Belvidere, IL 61008-2004
Phone
(779) 552-8358
Fax
(855) 552-3776
NPI assigned
Apr 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Christopher Parrett, DCNPI 1346554409
Title
Member
Phone
(779) 552-8358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X

Addresses

Primary practice location

1424 N State St
Belvidere, IL 61008-2004

Mailing address

1424 N State St
Belvidere, IL 61008-2004
Phone (779) 552-8358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220302001451 IL Part B Supplier - Clinic/Group Practice 6800280165 Receives reassigned benefits from 5 practitioners
Practice locations: Belvidere, IL; Rockford, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1255912341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 N STATE ST",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610082004",
            "telephone_number": "779-552-8358",
            "fax_number": "855-552-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 N STATE ST",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610082004",
            "telephone_number": "779-552-8358",
            "fax_number": "855-552-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS WOUND CARE CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "PARRETT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "779-552-8358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.