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General NPI Number Information
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NPI Number | 1184667933
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Entity Type | Organization
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Legal Business Name | ACCELERATED PROSTHETICS & ORTHOTICS INC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 05/31/2011
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Provider Practice Location Address
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Address Line | 1480 RENAISSANCE DRIVE SUITE 306
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 847-296-7755
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Fax | 847-296-7722
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Provider Business Mailing Address
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Address Line | 1480 RENAISSANCE DRIVE SUITE 306
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 847-296-7755
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Fax | 847-296-7722
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Authorized Official
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Title or Position | PRESIDENT
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Name | SOURABH V NAGALE
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Credential | CPO
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Telephone | 847-296-7755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 213000186
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 211000127
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License Number State | IL
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