Healthcare Provider Details

I. General information

NPI: 1083736672
Provider Name (Legal Business Name): AMERICAN LIMB AND ORTHOTIC CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 W HIGGINS AVE
CHICAGO IL
60630-2023
US

IV. Provider business mailing address

5800 W HIGGINS AVE
CHICAGO IL
60630-2023
US

V. Phone/Fax

Practice location:
  • Phone: 773-685-4998
  • Fax: 773-685-5155
Mailing address:
  • Phone: 773-685-4998
  • Fax: 773-685-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateIL

VIII. Authorized Official

Name: TERESA K. THORPE
Title or Position: PRESIDENT
Credential: CO
Phone: 773-685-4998