Organization
MIOMED ORTHOPAEDICS, INC.
Active
Other names
Obility
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALEXANDER SORENSEN (PRESIDENT)
(773) 477-8991
Entity
Organization
Contact information
Practice address
2502 N CLARK ST STE 207, CHICAGO, IL 60614-1850
(773) 477-8991
(773) 477-4001
Mailing address
2506 N CLARK ST STE 290, CHICAGO, IL 60614-1848
(773) 477-8991
(773) 477-4001
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203.001898
HME LICENSE NUMBER
IL
Enumeration date
11/28/2017
Last updated
11/21/2019
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