Organization
DUPAGE PROSTHETIC-ORTHOTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ROONEY C.P. (OWNER)
(630) 261-9317
Entity
Organization
Contact information
Practice address
410 W ICE LAKE RD, IRON RIVER, MI 49935-8417
(630) 261-9317
Mailing address
121 E ROOSEVELT RD, SUITE B, LOMBARD, IL 60148-4561
(630) 261-9317
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
211.000188
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740466101
—
IL
Enumeration date
03/19/2014
Last updated
03/19/2014
Update your record
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