Organization
MD ORTHOTIC & PROSTHETIC LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIT V BHANTI (CEO)
(309) 676-2276
Entity
Organization
Contact information
Practice address
1614 W CENTRAL RD STE 111, ARLINGTON HEIGHTS, IL 60005-2452
(847) 364-4865
(888) 635-3135
Mailing address
714 W MAIN ST, PEORIA, IL 61606-1952
(800) 334-5705
(888) 663-6322
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
060008643213000063
IL
Other
Enumeration date
01/18/2007
Last updated
11/26/2025
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