Integrated Wound Care Illinois Pllc

NPI #1700539780 in Springfield, Illinois

Provider Information

NPI Number: 1700539780
Entity Type: Organization
Organization Name: Integrated Wound Care Illinois Pllc
Primary Specialty: General Practice
Enumeration Date: Jan 31, 2022
Last Updated: Jan 31, 2022

Practice Location

Address: 801 ADLAI STEVENSON DR
City: Springfield
State: Illinois
ZIP Code: 62703-4261
Phone: (718) 963-3495

Authorized Official

Name: DR. DIANE LUSAS
Title: PRESIDENT
Phone: (718) 963-3495

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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