MD ORTHOTIC AND PROSTHETIC LABORATORY, INC – NPI #1881746758
Prosthetic/Orthotic Supplier

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

Health Care Provider Taxonomy Code for Prosthetic/Orthotic Supplier

MD ORTHOTIC AND PROSTHETIC LABORATORY, INC is a DME Supplier located in CHICAGO, IL. NPPES has assigned the NPI number 1881746758 to MD ORTHOTIC AND PROSTHETIC LABORATORY, INC on January 18, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 335E00000X from the Health Care Provider Taxonomy code set, which is classified as Prosthetic/Orthotic Supplier.

The NPI profile was previously updated about 6 years ago on Aug 05, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MD ORTHOTIC AND PROSTHETIC LABORATORY, INC below.

NPI Profile for
MD ORTHOTIC AND PROSTHETIC LABORATORY, INC

NPI Number
1881746758
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MD ORTHOTIC AND PROSTHETIC LABORATORY, INC
Primary location
4801 W PETERSON AVE
STE 402
CHICAGO, IL 60646
Phone: (773) 545-6047 Fax: (888) 635-3135
Mailing address
741 W MAIN ST
PEORIA, IL 61606-1953
Phone: (800) 334-5705 Fax: (888) 663-6322
Organization Subpart
No
Authorized Official
DONALD GOERTZEN
PRESIDENT
Phone: (309) 676-2276
Updated
Certification Date
Aug 05, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
335E00000X
- Prosthetic/Orthotic Supplier (Primary)		 IL 060008643213000063

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.