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Contact Information

MD ORTHOTIC AND PROSTHETIC LABORATORY, INC
4801 W PETERSON AVE
STE 402
CHICAGO, IL60646
 Phone: 773-545-6047
 Fax: 888-635-3135
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthetic/Orthotic Supplier

335E00000X 51 Medical Supply Company with Orthotist
Indicates primary specialty

NPI Profile & details for MD ORTHOTIC AND PROSTHETIC LABORATORY, INC

NPI # 1881746758
LBN Legal business name MD ORTHOTIC AND PROSTHETIC LABORATORY, INC
Authorized official DONALD GOERTZEN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/18/2007
Last updated 08/05/2020 - About 6 years ago
Identifiers
IL License # 060008643213000063
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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