Healthcare Provider Details
I. General information
NPI: 1417877705
Provider Name (Legal Business Name): PR ORTHOTICS & OT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1701 E WOODFIELD RD STE 816
SCHAUMBURG IL
60173-5133
US
IV. Provider business mailing address
1701 E WOODFIELD RD STE 816
SCHAUMBURG IL
60173-5133
US
V. Phone/Fax
- Phone: 224-470-8550
- Fax: 224-470-8553
- Phone: 224-470-8550
- Fax: 224-470-8553
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICIA
LOUISE
ROGEL
Title or Position: OWNER
Credential: CO, LO
Phone: 224-470-8550