Organization
NV ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ALLEN NOVAK CO (OWNER/ORTHOTIST)
(708) 651-2564
Entity
Organization
Contact information
Practice address
1675 W DEMPSTER ST, PARK RIDGE, IL 60068-1110
(708) 651-2564
Mailing address
5131 ELLINGTON AVE, WESTERN SPRINGS, IL 60558-2034
(708) 651-2564
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
04254422
IL
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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