OrganizationWoundcare At HomeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address514 Teela Ln, Des Plaines, IL 60016-1230(847) 337-1396PECOS EnrollmentBased on the most recent information from CMS, provider Woundcare At Home does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1902844400Provider TypeOrganizationFull NameWoundcare At HomeSubpartNoEnumeration Date6/4/2006Last Updated9/18/2008Contact InformationPractice LocationPractice Address514 Teela Ln, Des Plaines, IL 60016-1230Phone(847) 337-1396Fax(888) 845-9162Mailing LocationMailing Address514 Teela Ln, Des Plaines, IL 60016-1230Phone(847) 337-1396Fax(888) 845-9162Authorized OfficialNameMack, Susan A (President)Phone(847) 337-1396Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense060008633IllinoisProvider IdentifiersIDDescriptionIssuerID332520251001DescriptionMedicaidIssuerUnlistedIllinois