AT HOME WOUND CARE LLC — NPI 1417759457 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in ADDISON, IL)

CMS-1500 Box 24J / 33a • NPI

1417759457

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261Q00000X (CMS 70)

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

350 W NORTH AVE # LL, ADDISON, IL, 60101-4911

✓ 9-Digit EDI 837 ZIP+4 (60101-4911)

Practice Phone & Referral Fax

(773) 341-6516

Fax: (888) 984-4244

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1417759457 (AT HOME WOUND CARE LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1417759457` (NPI-2 Organization / Facility)
Provider / Legal Name	AT HOME WOUND CARE LLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261Q00000X` (Clinic/Center)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	350 W NORTH AVE # LL, ADDISON, IL, 60101-4911
Practice Telephone / Fax	Tel: (773) 341-6516 \| Fax: (888) 984-4244
Administrative Mailing Address	350 W NORTH AVE # LL, ADDISON, IL, 60101-4911
Enumeration & Last Sync	Enumerated: 2025-03-27 \| CMS Record Updated: 2025-04-14
Authorized Official	RENO LOOD (General Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

350 W NORTH AVE # LL, ADDISON, IL, 60101-4911

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Plain-English Taxonomy & CMS Crosswalk (261Q00000X)

What Does Taxonomy Code 261Q00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261Q00000X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 70 (Clinic or Group Practice)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AT HOME WOUND CARE LLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261Q00000X` — Clinic/Center Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AT HOME WOUND CARE LLC (NPI #1417759457)