Organization Active NPI

Affection Wound Care

  • Nurse Practitioner
  • Oak Park, IL
National Provider Identifier
1932945284
Registry record updated Jul 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
AFFECTION WOUND CARE
Practice address
101 N Marion St Ste 203
Oak Park, IL 60301-1023
Phone
(312) 714-3133
Fax
(312) 910-8971
NPI assigned
Jul 6, 2024
Last updated
Jul 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2024

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

Authorized official

Name
Gaelle Dwomoh, NPNPI 1831864099
Title
Advanced Practice Registered Nurse
Phone
(312) 714-3133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

101 N Marion St Ste 203
Oak Park, IL 60301-1023

Mailing address

101 N Marion St Ste 203
Oak Park, IL 60301-1023
Phone (312) 714-3133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250707001581 IL Part B Supplier - Clinic/Group Practice 6406360130 Receives reassigned benefits from 2 practitioners
Practice locations: Oak Park, IL

National Provider Directory

National Provider Directory

Locations

101 N Marion St
Ste 203
Oak Park, IL 60301
Phone (312) 714-3133

Practitioners & affiliated clinicians

Practitioners 4

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": "1720224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720224000000",
    "number": "1932945284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N MARION ST STE 203",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011023",
            "telephone_number": "312-714-3133",
            "fax_number": "312-910-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MARION ST STE 203",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011023",
            "telephone_number": "312-714-3133",
            "fax_number": "312-910-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFECTION WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-06",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A",
        "authorized_official_last_name": "DWOMOH",
        "authorized_official_first_name": "GAELLE",
        "authorized_official_title_or_position": "ADVANCED PRACTICE REGISTERED NURSE",
        "authorized_official_telephone_number": "312-714-3133",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.