MEDICARE: PR ORTHOTICS & OT, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	335E00000X	Prosthetic/Orthotic Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	222Z00000X	Orthotist

General Provider Information

NPI Number	:	1811418015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PR ORTHOTICS & OT, LLC

Provider Business Mailing Address
First Line	:	4711 GOLF RD STE 525
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-1217
Country	:	US
Telephone Number	:	224-470-8550
Fax Number	:	224-470-8553

Provider Business Practice Location Address
First Line	:	4711 GOLF ROAD
Second Line	:	SUITE 525
City	:	SKOKIE
State	:	IL
Zip	:	60076
Country	:	US
Telephone Number	:	224-470-8550
Fax Number	:	224-470-8553

Authorized Official
Title or Position	:	OWNER/ORTHOTIST
Name	:	PATRICIA LOUISE ROGEL
Credential	:	CO
Telephone Number	:	224-470-8550

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	02/12/2026

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Directions to “PR ORTHOTICS & OT, LLC ” Practice Location

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