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NPI Code Detail

MEDICARE: DREHER ORTHOTICS & PROSTHETICS INC

MEDICARE: DREHER ORTHOTICS & 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
1222Z00000XOrthotist
2224P00000XProsthetist
3335E00000XProsthetic/Orthotic Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
181997OTHERNORTHWOOD INS PROVIDER ID
201670158OTHERILBCBS PROVIDER ID

General Provider Information

NPI Number : 1578567236
Entity Type Code : Organization
Provider Name (Legal Business Name) : DREHER ORTHOTICS & PROSTHETICS INC
Provider Business Mailing Address
First Line : 7350 W 119TH ST
Second Line : STE 205
City : PALOS HEIGHTS
State : IL
Zip : 60463-1189
Country : US
Telephone Number : 708-448-6909
Fax Number : 708-448-1581
Provider Business Practice Location Address
First Line : 7350 W 119TH ST
Second Line : STE 205
City : PALOS HEIGHTS
State : IL
Zip : 60463-1189
Country : US
Telephone Number : 708-448-6909
Fax Number : 708-448-1581
Authorized Official
Title or Position : OWNER PRESIDENT
Name : MR. PETER DREHER
Credential : C.O.
Telephone Number : 708-448-6909
Provider Enumeration Date : 06/10/2005
Last Update Date : 09/13/2012

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Directions to “DREHER ORTHOTICS & PROSTHETICS INC ” Practice Location

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