Midwest Wound Care Incorporated

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MIDWEST WOUND CARE INCORPORATED

Practice address

1190 Lily Cache LN Apt 103
Bolingbrook, IL 60490-3284

Phone

(630) 731-4492

NPI assigned

Dec 11, 2024

Organization subpart

No

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

Authorized official

Name

Ruth Odamtten

Title

President

Phone

(630) 731-4492

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

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

• Taryrsha Davis, APN

  • Nurse Practitioner
  • Naperville, IL
  • NPI 1821552761
  Medicare reassignment Care Compare group NPD
• Monica Medrano, MD, MS

  • Family Medicine Physician
  • Michigan City, IN
  • NPI 1821655663

  IL

  Medicare reassignment Care Compare group NPD
• Eunice Otuwa Cromwell, DNP, APRN

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1710446885
  Medicare reassignment NPD
• Marlin Reyes, BC

  • Family Nurse Practitioner
  • Downers Grove, IL
  • NPI 1164998258
  Medicare reassignment NPD

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1538976873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 LILY CACHE LN APT 103",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604903284",
            "telephone_number": "630-731-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 LILY CACHE LN APT 103",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604903284",
            "telephone_number": "630-731-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST WOUND CARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "ODAMTTEN",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-731-4492"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Micek, MOT/L,CHT
• Midwest Express Care 2, Inc
• Midwest Functional Psychiatry
• Midwest Hyperbaric Institute, P.C.
• Midwest Rehabilitation & Wellness Center
• Shunta M Milam, AAS, BA, M.ED, MBA
• Vincent Miller
• Mindful Occupational Therapy LLC
• Allison Mitch, DPT
• Donita Mitchell-Gage, CERTIFIED HAIR LOSS

• Internal Medicine Physician in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.