Organization Active NPI

Integrity Medical and Wounds Group Il RLLP

  • Specialist
  • Chicago, IL
National Provider Identifier
1689405078
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
INTEGRITY MEDICAL AND WOUNDS GROUP IL RLLP
Practice address
8600 W Bryn Mawr Ave # 8700
Chicago, IL 60631-3579
Phone
(702) 580-7997
NPI assigned
Aug 8, 2024
Last updated
Nov 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Authorized official

Name
Jacqueline Garalde Walker
Title
Owner
Phone
(702) 580-7997

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

8600 W Bryn Mawr Ave # 8700
Chicago, IL 60631-3579

Mailing address

8770 W Bryn Mawr Ave Ste 1300
Chicago, IL 60631-3557
Phone (702) 580-7997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241210004708 IL Part B Supplier - Clinic/Group Practice 4385170612 Receives reassigned benefits from 10 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

8600 W Bryn Mawr Ave
#8700
Chicago, IL 60631
Phone (702) 580-7997

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1689405078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8770 W BRYN MAWR AVE STE 1300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313557",
            "telephone_number": "702-580-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 W BRYN MAWR AVE # 8700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313579",
            "telephone_number": "702-580-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY MEDICAL AND WOUNDS GROUP IL RLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "GARALDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-580-7997"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.