NPIMap

Organization Active NPI

Optech Orthotics & Prosthetics Corp

  • Prosthetic/Orthotic Supplier
  • Morris, IL
National Provider Identifier
1194919167
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
OPTECH ORTHOTICS & PROSTHETICS CORP
Practice address
111 W Jackson St
Morris, IL 60450
Phone
(815) 741-9700
Fax
(815) 741-4701
NPI assigned
Aug 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Martin B McNab Jr., CPO
Title
Certified Orthotist Prosthotist Pre
Phone
(815) 932-8564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X IL Primary

Addresses

Primary practice location

111 W Jackson St
Morris, IL 60450

Mailing address

111 W Jackson St
Morris, IL 60450
Phone (815) 741-9700

Other identifiers 2

IdentifierTypeStateIssuer
80543OtherILNORTHWOOD UHC
04622011OtherILBCBS

National Provider Directory

National Provider Directory
Tax ID family
Optech Orthotics Prosthetics Corp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1194919167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W JACKSON ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-741-9700",
            "fax_number": "815-741-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JACKSON ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-741-9700",
            "fax_number": "815-741-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTECH ORTHOTICS & PROSTHETICS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "MCNAB",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CERTIFIED ORTHOTIST PROSTHOTIST PRE",
        "authorized_official_telephone_number": "815-932-8564",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHWOOD UHC",
            "identifier": "80543",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04622011",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.