Ec Physician and Wound Specialist LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036076935 Issued in IL

Legal business name

EC PHYSICIAN AND WOUND SPECIALIST LLC

Practice address

1000 N Westmoreland Rd
Lake Forest, IL 60045

Phone

(847) 535-7600

NPI assigned

May 29, 2018

Organization subpart

No

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

Authorized official

Name

Elisabeth Kerns Cormier, MD

Title

Physician

Phone

(847) 998-0862

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1689165490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 GLENDALE DR",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600254412",
            "telephone_number": "847-998-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "60045",
            "telephone_number": "847-535-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EC PHYSICIAN AND WOUND SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "CORMIER",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_middle_name": "KERNS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-998-0862",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036076935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane L Duddles, NP
• Casey Dugan, PA-C
• VI Duong, M.D.
• Robert T Durrett, DDS
• Landon Jess Duyka, M.D.
• Nancy D Ehrhardt, RPH
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• Kristin Rae Elinski, PA-C
• Madeline Ellis, DNP, AG-ACNP-BC
• Rizamarie E Empeno, MD

• Internal Medicine Physician in Lake Forest, IL
• Providers in Lake Forest, 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 Aug 14, 2018; 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.