Organization Active NPI

Pediatric Orthotic and Prosthetic Services - Midwest, LLC

  • Prosthetic/Orthotic Supplier
  • Chicago, IL
National Provider Identifier
1760835938
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - MIDWEST, LLC
Practice address
2211 N Oak Park Ave
Chicago, IL 60707-3351
Phone
(773) 385-5848
NPI assigned
Jul 22, 2016
Organization subpart
Yes
Parent organization
PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - MIDWEST, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Mr. William C Craggs, CPO, LPO
Title
Manager, Orthotics and Prosthetics
Phone
(773) 466-6922

Specialties & licenses 1

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

Addresses

Primary practice location

2211 N Oak Park Ave
Chicago, IL 60707-3351

Mailing address

PO Box 947109
Atlanta, GA 30394-7109
Phone (813) 367-2876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171012002910 IL DME Supplier - Medical Supply Company With Orthotic-Prosthetic 9436463288 Practice locations: Chicago, IL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pediatric Orthotic and Prosthetic2211 N Oak Park Ave, Chicago, IL 60707-3351(773) 466-6922 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Apr 20, 2015

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Orthotic and Prosthetic Services-Midwest LLC3 organizations share this tax ID, including this one
Part of
Pediatric Orthotic and Prosthetic Services-Midwest LLC

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1760835938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947109",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947109",
            "telephone_number": "813-367-2876",
            "fax_number": "813-518-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 N OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073351",
            "telephone_number": "773-385-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - MIDWEST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - MIDWEST, LLC",
        "enumeration_date": "2016-07-22",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "CRAGGS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER, ORTHOTICS AND PROSTHETICS",
        "authorized_official_telephone_number": "773-466-6922",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO, LPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.