Healthcare Provider Details

I. General information

NPI: 1174477806
Provider Name (Legal Business Name): QUANTUM PROSTHETICS & ORTHOTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17224 HARLEM AVE
TINLEY PARK IL
60477-3368
US

IV. Provider business mailing address

17224 HARLEM AVE
TINLEY PARK IL
60477-3368
US

V. Phone/Fax

Practice location:
  • Phone: 312-300-4472
  • Fax: 312-300-4473
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VIKRAM CHOUDHARY
Title or Position: PRESIDENT
Credential:
Phone: 312-300-4472