KOEBERS PROSTHETIC & ORTHOTIC LAB INC.; NPI #1700936234

Contact Information

KOEBERS PROSTHETIC & ORTHOTIC LAB INC.

3834 W IRVING PARK RD
CHICAGO, IL 60618

Phone: 773-539-7333
Fax: 773-539-5535
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Prosthetic/Orthotic Supplier	335E00000X	51	Medical Supply Company with Orthotist

Indicates primary specialty

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NPI Profile & details for KOEBERS PROSTHETIC & ORTHOTIC LAB INC.

NPI # 1700936234

LBN Legal business name KOEBERS PROSTHETIC & ORTHOTIC LAB INC.

Authorized official DONALD GOERTZEN - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/10/2007

Last updated 07/30/2018 - About 8 years ago

Identifiers

Other

01680020

BLUE CROSS BLUE SHIELD

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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