Organization
OPTECH ORTHOTICS & PROSTHETICS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN B MCNAB JR. CPO (CERTIFIED ORTHOTIST PROSTHETIST)
(815) 932-8564
Entity
Organization
Contact information
Practice address
119 E COURT ST STE 100, KANKAKEE, IL 60901-3823
(815) 932-8564
(815) 932-8640
Mailing address
119 E COURT ST STE 100, KANKAKEE, IL 60901-3823
(815) 932-8564
(815) 932-8640
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04622011
BCBS
IL
01
—
80544
NORTHWOOD UHC
IL
Enumeration date
03/10/2006
Last updated
06/01/2011
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