SKYLINE WOUND CARE MIDWEST LLC – Plastic and Reconstructive Surgery Physician, NPI 1295445179

SKYLINE WOUND CARE MIDWEST LLC is a healthcare provider. based in Peoria, Illinois. specializing in Plastic and Reconstructive Surgery Physician. The NPI Number for SKYLINE WOUND CARE MIDWEST LLC is 1295445179

Main info

Organization
Name
SKYLINE WOUND CARE MIDWEST LLC
NPI
1295445179
Phone
(309) 693-1400
Address
6900 N Stalworth Dr
Authorized Official
SHARON PALACIOS CREDENTIALING COORDINATOR
Enumeration Date
1 December 2022
Last Update Date
31 March 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:3State licenses:0Digital endpointsOther names

Provider Addresses for SKYLINE WOUND CARE MIDWEST LLC

  • 6900 N Stalworth Dr

    Peoria, IL 616159444

    Phone: (309) 693-1400

    Type: Location

  • 7742 N KENDALL DR # 446

    MIAMI, FL 331567523

    Phone: (877) 970-4200

    Fax: (786) 677-4292

    Type: Mailing

  • 7901 4TH ST N

    STE 300

    ST. PETERSBURG, FL 33702

    Phone: (877) 970-4200

    Fax: (786) 677-4292

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20230613000812OClinic/Group PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61615)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for SKYLINE WOUND CARE MIDWEST LLC?
SKYLINE WOUND CARE MIDWEST LLC — NPI 1295445179 — is the standard way to identify this listing.
Is SKYLINE WOUND CARE MIDWEST LLC still practicing?
SKYLINE WOUND CARE MIDWEST LLC is currently listed as active in the public NPI registry.
What is SKYLINE WOUND CARE MIDWEST LLC's specialty?
The listing groups SKYLINE WOUND CARE MIDWEST LLC with Plastic and Reconstructive Surgery Physician. Clinical services aligned with this taxonomy classification.
Where should I expect SKYLINE WOUND CARE MIDWEST LLC on a map?
Expect Peoria, Illinois as a primary anchor for SKYLINE WOUND CARE MIDWEST LLC unless the record lists multiple sites.
Is the information about SKYLINE WOUND CARE MIDWEST LLC up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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