MEDICARE: SCHECK & SIRESS PROSTHETICS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	01662432	IL
2	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1073578944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHECK & SIRESS PROSTHETICS, INC

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 W HARRISON ST STE 220
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3836
Country	:	US
Telephone Number	:	312-942-2011
Fax Number	:	312-942-0874

Authorized Official
Title or Position	:	REG COMPLIANCE SPECIALIST III
Name	:	GRACE ANGELINE
Credential	:
Telephone Number	:	714-961-2102

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	02/09/2021

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