NPIMap

Organization Active NPI

Nova Medico S.C.

Doing business as Chicago Wound Care

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Park Ridge, IL
National Provider Identifier
1871689208
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
036092302 Issued in IL
Legal business name
NOVA MEDICO S.C.
Doing business as
Chicago Wound Care
Practice address
1480 Renaissance Dr Ste 211
Park Ridge, IL 60068-1353
Phone
(847) 296-6161
Fax
(847) 296-6262
NPI assigned
Oct 5, 2006
Last updated
Jul 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Kimberly Miller
Title
Director of RCM
Phone
(248) 331-7908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 036092302 IL Primary

Addresses

Primary practice location

1480 Renaissance Dr Ste 211
Park Ridge, IL 60068-1353

Mailing address

PO Box 5633
Carol Stream, IL 60197-5633
Phone (847) 296-6161

Other practice location 1

1560 Wall St Ste 304
Naperville, IL 60563-1262
Phone (847) 296-6161

Other practice location 2

105 Water St
Plymouth, IN 46563-2148
Phone (888) 402-0202

Other practice location 3

9730 S Western Ave Ste B
Evergreen Park, IL 60805-2814
Phone (847) 296-6161

Other names 1

  • Chicago Wound Care Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071219000058 IL Part B Supplier - Clinic/Group Practice 9133219827 Receives reassigned benefits from 24 practitioners
Practice locations: Evergreen Park, IL; Park Ridge, IL
O20250926003939 IN Part B Supplier - Clinic/Group Practice 9133219827 Receives reassigned benefits from 2 practitioners
Practice locations: Plymouth, IN

National Provider Directory

National Provider Directory

Locations

1455 E Golf Rd
Ste 207
Des Plaines, IL 60016
Phone (847) 296-6161

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1871689208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5633",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601975633",
            "telephone_number": "847-296-6161",
            "fax_number": "847-296-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 RENAISSANCE DR STE 211",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681353",
            "telephone_number": "847-296-6161",
            "fax_number": "847-296-6262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 Wall St Ste 304",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605631262",
            "country_code": "US",
            "telephone_number": "847-296-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Water St",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "IN",
            "postal_code": "465632148",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "fax_number": "888-860-2960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9730 S Western Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052814",
            "country_code": "US",
            "telephone_number": "847-296-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVA MEDICO S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "248-331-7908"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IL",
            "license": "036092302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Chicago Wound Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.