PR ORTHOTICS & OT LLC (NPI# 1811418015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811418015 |
Entity Type | Organization |
Organization Name | PR ORTHOTICS & OT LLC |
Other Organization Name | CHICAGO PEDIATRIC ORTHOTICS |
Practice Address |
4711 Golf Rd Skokie IL 60076-1224 |
Mailing Address |
4711 Golf Rd Ste 1055 Skokie IL 60076-1272 |
Practice Telephone | 7738993885 |
Mailing Telephone | 2244708550 |
Mailing Fax Number | 2244708553 |
Enumeration Date | 2017-06-28 |
Last Update Date | 2020-06-23 |
Authorized Official Name | PATRICIA LOUISE ROGEL (OWNER) |
Authorized Official Telephone | 2244708550 |
Authorized Official Credential | CO, OTR |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 1841338860 | 05 |
Other Name | Type Code |
---|---|
Chicago Pediatric Orthotics | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730724394 | Pr Orthotics & Ot LLC | Orthotist | 4711 Golf Rd Ste 1055, Skokie, IL 60076-1272 | 2019-11-07 |
Street Address |
4711 GOLF RD |
City | SKOKIE |
State | IL |
Zip Code | 60076-1224 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497752893 | Alice Chen | Legal Medicine | 4711 Golf Rd, Suite 808, Skokie, IL 60076-1224 | 2005-06-30 |
1528507548 | Elizabeth Hultman | Nurse Practitioner | 4711 Golf Rd, Skokie, IL 60076-1224 | 2017-02-23 |
1609314616 | Mary Lally | Behavioral Analyst | 4711 Golf Rd, Suite 100, Skokie, IL 60076-1224 | 2017-02-09 |
1821536822 | Steinberg Behavior Solutions | Community/Behavioral Health | 4711 Golf Rd, Suite 100, Skokie, IL 60076-1224 | 2017-02-09 |
1205372067 | Olasunkanmi Ogedegbe | Nurse Practitioner | 4711 Golf Rd, Suite 1250, Skokie, IL 60076-1224 | 2017-01-17 |
1952858409 | Marissa Bennett | Behavioral Analyst | 4711 Golf Rd, 100, Skokie, IL 60076-1224 | 2016-09-01 |
1326495243 | Michelle Fisher | Social Worker | 4711 Golf Rd, Suite 400, Skokie, IL 60076-1224 | 2016-05-20 |
1336503119 | Rebecca Arends | Counselor | 4711 Golf Rd, Suite 1200, Skokie, IL 60076-1224 | 2016-04-07 |
1992169015 | Jarret Helstern | Nurse Practitioner | 4711 Golf Rd, Suite 1200, Skokie, IL 60076-1224 | 2016-04-06 |
1255793162 | Julie Pak | Nurse Practitioner | 4711 Golf Rd, Suite 1250, Skokie, IL 60076-1224 | 2016-03-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902456999 | Gateway Foundation, Inc | Clinic/Center | 4028 W. Dempster, Ste 100, Skokie, IL 60076 | 2019-09-12 |
1336798255 | Renee Rosenberg | Speech-Language Pathologist | C/o East Prairie School, 7616 N. East Prairie Road, Skoke, IL 60076 | 2019-09-04 |
1710531223 | Dw Care Solutions | Hospice Care, Community Based | 4556 Oakton St, Suite 205, Skokie, IL 60076 | 2019-08-01 |
1689228157 | Elaine Ng | Pharmacist | 9650 Gross Point Rd Suite 4900, Skokie, IL 60076 | 2019-08-01 |
1881169381 | Kathleen Pyles | Registered Nurse | 9650 Gross Point Rd # 4900, Skokie, IL 60076 | 2018-10-10 |
1174013452 | Vitae Health of Illinois LLC | Social Worker | 3450 Oakton St, Skokie, IL 60076 | 2018-05-13 |
1396253530 | Jodi Novick Okner | Social Worker | 9134 Kilbourn Avenue, Skokie, IL 60076 | 2018-01-22 |
1700335924 | Olumide Adeyemo | Nurse Practitioner | 4711 Golf Rd Suite 1250, Skokie, IL 60076 | 2016-09-28 |
1255705315 | Malka Rokach | Pharmacist | 3358 W Touhy, Skokie, IL 60076 | 2015-11-30 |
1578932620 | Katrina Margaret Keithley | Physician Assistant | 9669 Kenton Ave Ste 203, Skokie, IL 60076 | 2015-09-18 |
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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 |
---|---|---|---|---|
1912307992 | Presque Isle Orthotics and Prosthetics of Ohio, LLC | Prosthetic/Orthotic Supplier | 3700 Oakton St Ste 103, Skokie, IL 60076-3407 | 2014-08-27 |
1447485545 | Scheck & Siress Prosthetics, Inc | Prosthetic/Orthotic Supplier | 5202 Old Orchard Rd Ste N100, Skokie, IL 60077-4407 | 2009-05-19 |
1023043502 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 77 Old Orchard Shopping Ctr, Skokie, IL 60077-1406 | 2006-07-12 |
1134244742 | Cranial Technologies Inc | Prosthetic/Orthotic Supplier | 4709 Golf Rd, Suite 510, Skokie, IL 60076-1277 | 2007-03-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952909517 | Matayah Love | Prosthetic/Orthotic Supplier | 5833 W Madison St, Chicago, IL 60644-3840 | 2020-10-15 |
1225653686 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1290 W Northwest Hwy, Palatine, IL 60067-1897 | 2020-06-11 |
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 |
1134748767 | The Weave Luxe Bar | Prosthetic/Orthotic Supplier | 7315 Lemont Rd, Downers Grove, IL 60516-3807 | 2020-04-14 |
1245865245 | Ortheco LLC | Prosthetic/Orthotic Supplier | 3050 Montvale Dr Ste E, Springfield, IL 62704-4290 | 2020-03-10 |
1417515784 | Dionne Williams Group | Prosthetic/Orthotic Supplier | 6822 S Wood St, Chicago, IL 60636-3337 | 2019-06-03 |
1164080743 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 391 Quadrangle Dr Ste N4, Bolingbrook, IL 60440-3443 | 2019-05-30 |
1760047583 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 13500 Circle Dr Ste 202, Orland Park, IL 60462-1343 | 2019-05-07 |
1114580107 | Thomas Gavin | Prosthetic/Orthotic Supplier | 1010 Jorie Blvd Ste 24, Oak Brook, IL 60523-4450 | 2019-04-16 |
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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.