Organization
OMNICARE LABS OF CHAMPAIGN INC
Active
Other names
OMNI PROSTHETICS AND ORTHOTICS INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM R DEVLIN CPO (PROSTHETIST ORTHOTIST)
(217) 344-6664
Entity
Organization
Contact information
Practice address
502 S VINE ST, URBANA, IL 61801-4220
(217) 344-6664
(217) 344-9282
Mailing address
502 S VINE ST, URBANA, IL 61801-4220
(217) 344-6664
(217) 344-9282
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
211000198
IL
335E00000X
Prosthetic/Orthotic Supplier
213000216
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01032029
BLUECROSS BLUESHIELD
IL
01
—
02628
ABC CERTIFICATION
IL
01
—
082258
HEALTH ALLIANCE
IL
Enumeration date
12/21/2006
Last updated
05/23/2025
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