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General NPI Number Information
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NPI Number | 1982011102
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Entity Type | Organization
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Legal Business Name | ABILITY PROSTHETIC AND ORTHOTIC CARE INC.
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 07/21/2014
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Provider Practice Location Address
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Address Line | 4710 W 95TH ST SUITE 11
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City | OAK LAWN
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State | IL
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Zip | 60453-2546
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Country | US
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Telephone | 708-529-0753
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Fax |
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Provider Business Mailing Address
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Address Line | 4710 W 95TH ST SUITE 11
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City | OAK LAWN
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State | IL
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Zip | 60453-2546
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Country | US
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Telephone | 708-529-0753
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Fax |
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Authorized Official
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Title or Position | CERTIFIED PROSTHETIST AND ORTHOTIST
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Name | MR. NACER KHENOUCHE
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Credential |
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Telephone | 708-529-0753
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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 | 211.000279
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License Number State | IL
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