BREANNA ANGELA BALTRUSCH (NPI# 1396371225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396371225 |
Entity Type | Individual |
Full Name | BREANNA ANGELA BALTRUSCH |
Credential | CPO, LPO |
Practice Address |
2515 N Clark St Ste 802 Chicago IL 60614-2730 |
Mailing Address |
225 E Chicago Ave # 46 Chicago IL 60611-2991 |
Practice Telephone | 3122276210 |
Mailing Telephone | 3122276210 |
Enumeration Date | 2020-03-23 |
Last Update Date | 2020-03-23 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 222Z00000X | Orthotist | 213.000402 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
N | 224P00000X | Prosthetist | 211.000354 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
2515 N CLARK ST STE 802 |
City | CHICAGO |
State | IL |
Zip Code | 60614-2730 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306981345 | Matthew Alan Goddard | Orthotist | 2515 N Clark St Ste 802, Chicago, IL 60614-2730 | 2007-02-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
Find all providers in zip 60614 |
Taxonomy Code | 222Z00000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Orthotist |
A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831691104 | Ashley Zinnamon | Orthotist | 1525 E 55th St Ste 204, Chicago, IL 60615-5512 | 2018-03-02 |
1699896431 | Timothy W Porcelli | Orthotist | 3723 N Southport, Chicago, IL 60613-3718 | 2007-04-02 |
1306981345 | Matthew Alan Goddard | Orthotist | 2515 N Clark St Ste 802, Chicago, IL 60614-2730 | 2007-02-20 |
1386781755 | Andreas Josef Bohner | Orthotist | 2300 N Childrens Plz # 46, Chicago, IL 60614-3363 | 2007-02-01 |
1568509040 | Robert Allen Novak | Orthotist | 5521 N Cumberland Ave, Suite 1115, Chicago, IL 60656-4717 | 2007-01-31 |
1063062370 | Michael Socie | Orthotist | 355 E Erie St, Chicago, IL 60611-3167 | 2019-09-18 |
1679034177 | Sara L Jerousek | Orthotist | 225 E Chicago Ave, Chicago, IL 60611 | 2019-03-27 |
1083195424 | Erin Claussen | Orthotist | 225 E Chicago Ave # 46, Chicago, IL 60611-2991 | 2018-08-23 |
1215423843 | Sourabh Nagale | Orthotist | 2515 N Clark St, Ste 802, Chicago, IL 60614 | 2018-07-06 |
1447747308 | Michael Elsen | Orthotist | 1725 W Harrison St Ste 220, Chicago, IL 60612-3836 | 2018-04-17 |
Find all providers in CHICAGO |
Please comment or provide details below to improve the information on BREANNA ANGELA BALTRUSCH.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.