Suburban Wound Care Associates, LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

036071841 Issued in IL

Legal business name

SUBURBAN WOUND CARE ASSOCIATES, LLC

Practice address

17800 Kedzie Ave
Hazel Crest, IL 60429-2029

Phone

(708) 799-8000

NPI assigned

Mar 18, 2009

Last updated

Mar 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Dreyfuss, MD

Title

Mamber

Phone

(815) 806-9400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1649411844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1664",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604237664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292029",
            "telephone_number": "708-799-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN WOUND CARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "DREYFUSS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MAMBER",
        "authorized_official_telephone_number": "815-806-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036071841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.