MEDICARE: ILLUSIONS MEDICAL PROSTHETICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1780524942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILLUSIONS MEDICAL PROSTHETICS LLC

Provider Business Mailing Address
First Line	:	5703 READ BLVD STE J
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-7908
Country	:	US
Telephone Number	:	504-982-2377
Fax Number	:

Provider Business Practice Location Address
First Line	:	5703 READ BLVD STE J
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-7908
Country	:	US
Telephone Number	:	504-982-2377
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KASHONE JORDAN
Credential	:
Telephone Number	:	504-982-2377

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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