PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - MIDWEST, LLC (NPI# 1760835938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760835938 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - MIDWEST, LLC |
| Practice Address |
2211 N Oak Park Ave Chicago IL 60707-3351 |
| Mailing Address |
Po Box 865109 Orlando FL 32886-5109 |
| Practice Telephone | 7733855848 |
| Mailing Telephone | 8446023960 |
| Mailing Fax Number | 8135187659 |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |
| Authorized Official Name | MR. WILLIAM C CRAGGS (MANAGER, ORTHOTICS AND PROSTHETICS) |
| Authorized Official Telephone | 7733855848 |
| Authorized Official Credential | CPO, LPO |
| Is Organization Subpart | Y |
| Parent Organization Name | PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - MIDWEST, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154721785 | Pediatric Orthotic and Prosthetic Services - Midwest, LLC | Prosthetic/Orthotic Supplier | 2025 E River Pkwy, Minneapolis, MN 55414-3604 | 2014-09-02 |
| Street Address |
2211 N OAK PARK AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60707-3351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790770659 | Shubhra Mukherjee | Pediatrics | 2211 N Oak Park Ave, Chicago, IL 60707-3392 | 2005-09-16 |
| 1134740111 | Emily Mary Thomas | Occupational Therapist | 2211 N Oak Park Ave, Chicago, IL 60707-3351 | 2020-05-01 |
| 1093335770 | Kyle Cressy Deane | Psychologist | 2211 N Oak Park Ave, Chicago, IL 60707-3392 | 2020-04-22 |
| 1295299600 | Allison Ragins | Physician Assistant | 2211 N Oak Park Ave, Chicago, IL 60707-3351 | 2019-01-30 |
| 1033686878 | Katrina Marie Vogel | Physician Assistant | 2211 N Oak Park Ave, Chicago, IL 60707-3392 | 2018-10-30 |
| 1326536574 | Shriners Hospitals for Children | Anesthesiology | 2211 N Oak Park Ave, Chicago, IL 60707-3351 | 2018-04-24 |
| 1427550748 | Elizabeth Hampton | Physical Therapist | 2211 N Oak Park Ave, Chicago, IL 60707-3351 | 2018-03-02 |
| 1366986184 | Lynn Freedman | Nurse Practitioner | 2211 N Oak Park Ave, Chicago, IL 60707-3351 | 2016-12-13 |
| 1992256531 | Kelsey Lynn Moon | Physician Assistant | 2211 N Oak Park Ave, Chicago, IL 60707-3392 | 2016-10-19 |
| 1639539984 | Elana Blivaiss | Nurse Practitioner | 2211 N Oak Park Ave, Chicago, IL 60707-3351 | 2016-02-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679077408 | Karen Ennis, Slp, Inc. | Speech-Language Pathologist | 1709 73rd Ct, Elmood Park, IL 60707 | 2018-03-19 |
| 1518324995 | Dosha Grant | Registered Nurse | 2317 N Rutherford, Elmwood Park, IL 60707 | 2016-01-15 |
| 1962774794 | Oak Park Dental Group | Dentist | 7034 W. North Ave., Chicago, IL 60707 | 2012-02-09 |
| 1326277005 | Resurrection Services | Internal Medicine | 2433 North Harlem Ave, Ste 100, Chicago, IL 60707 | 2009-07-02 |
| 1134370059 | Mefagui Dental Office P.C. | Dentist | 6913 W. Grand Ave, Chicago, IL 60707 | 2008-10-09 |
| 1821265760 | Carly M. Smith | Chiropractor | 7716 W. North, Elmwood Pk, IL 60707 | 2008-05-09 |
| 1063695096 | Henry J. Hagopian D.d.s. P.C. | Dentist | 7518 W. North Avenue, Elmwood Park, IL 60707 | 2007-12-13 |
| 1386864411 | Brian M Caraba Dds PC | Dentist | 7124 W Diversey Ave, Chicago, IL 60707 | 2007-04-30 |
| 1104041243 | Clinics for Wellness and Neuropathy, LLC | Internal Medicine | 2333 N. Harlem, Chicago, IL 60707 | 2007-04-16 |
| 1972621050 | Sid Anderson | Psychologist | 2408 Westbrook Drive, Elmwood Park, IL 60707 | 2007-03-27 |
| Find all providers in zip 60707 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | 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. |
| 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 |
|---|---|---|---|---|
| 1952909517 | Matayah Love | Prosthetic/Orthotic Supplier | 5833 W Madison St, Chicago, IL 60644-3840 | 2020-10-15 |
| 1710508239 | Vivian Danielle Williams | Prosthetic/Orthotic Supplier | 940 N Monticello Ave # 1, Chicago, IL 60651-3949 | 2020-05-06 |
| 1265053136 | Dfined Beauty LLC | Prosthetic/Orthotic Supplier | 1507 E 53rd St # 835, Chicago, IL 60615-4573 | 2020-05-02 |
| 1417515784 | Dionne Williams Group | Prosthetic/Orthotic Supplier | 6822 S Wood St, Chicago, IL 60636-3337 | 2019-06-03 |
| 1801358734 | Dionne Williams | Prosthetic/Orthotic Supplier | 1130 N Dearborn St Apt 2511, Chicago, IL 60610-2752 | 2019-04-01 |
| 1083174064 | Scheck & Siress Prosthetics, Inc | Prosthetic/Orthotic Supplier | 233 E Erie St Ste 200, Chicago, IL 60611-5938 | 2019-03-25 |
| 1366976243 | United Medical Market, Inc | Prosthetic/Orthotic Supplier | 1930 W Estes Ave, #104, Chicago, IL 60626-2363 | 2017-04-17 |
| 1124563218 | Ace Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 4315 N Lincoln Ave, Chicago, IL 60618-1711 | 2016-12-27 |
| 1174072276 | Eyepothecary | Prosthetic/Orthotic Supplier | 1726 W Chicago Ave, Chicago, IL 60622-5000 | 2016-09-30 |
| 1932652567 | Md Orthotic & Prosthetic Laboratory, Inc. | Prosthetic/Orthotic Supplier | 1514 E 87th St Lowr Level, Chicago, IL 60619 | 2016-08-01 |
| Find all providers in CHICAGO | ||||
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| 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.