MD Orthotic & Prosthetic Laboratory, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

211000147 Issued in IL

Legal business name

MD ORTHOTIC & PROSTHETIC LABORATORY, INC.

Doing business as

Comprehensive Prosthetics & Orthotics

Practice address

8741 S Greenwood Ave Ste 101
Chicago, IL 60619-7058

Phone

(773) 779-5869

Fax

(773) 779-8869

NPI assigned

Aug 1, 2016

Last updated

Sep 2, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kendra F Mickelson

Title

Manager of Revenue Cycle Management

Phone

(309) 285-7752

Specialties & licenses 1

Addresses

Other names 1

• Comprehensive Prosthetics & Orthotics Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

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

• MD Orthotic & Prosthetic Laboratory, Inc.

  • Prosthetic/Orthotic Supplier
  • Arlington Heights, IL
  • NPI 1043362932

  2567589658

  Same PAC ID
• MD Orthotic and Prosthetic Laboratory, Inc

  • Prosthetic/Orthotic Supplier
  • Oak Lawn, IL
  • NPI 1205988797

  2567589658

  Same PAC ID
• MD Orthotic and Prosthetic Laboratory, Inc

  • Prosthetic/Orthotic Supplier
  • Joliet, IL
  • NPI 1679625560

  2567589658

  Same PAC ID

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

Tax ID family

MD Orthotic and Prosthetic Laboratory Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

• MD Orthotic & Prosthetic Laboratory, Inc.

  • Prosthetic/Orthotic Supplier
  • Arlington Heights, IL
  • NPI 1043362932
  NPD tax ID
• MD Orthotic and Prosthetic Lab

  • Prosthetic/Orthotic Supplier
  • Joliet, IL
  • NPI 1649322512
  NPD tax ID
• MD Orthotic and Prosthetic Laboratory, Inc

  • Prosthetic/Orthotic Supplier
  • Oak Lawn, IL
  • NPI 1205988797
  NPD tax ID
• MD Orthotic and Prosthetic Laboratory, Inc

  • Prosthetic/Orthotic Supplier
  • Naperville, IL
  • NPI 1376226910
  NPD tax ID
• MD Orthotic and Prosthetic Laboratory, Inc

  • Prosthetic/Orthotic Supplier
  • Joliet, IL
  • NPI 1679625560
  NPD tax ID
• MD Orthotic and Prosthetic Laboratory, Inc.

  • Prosthetic/Orthotic Supplier
  • Olympia Fields, IL
  • NPI 1699159624
  NPD tax ID

Member of 1

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

• Cpo Services, Inc

  dba Comprehensive Prosthetics & Orthotics

  • Prosthetic/Orthotic Supplier
  • Quincy, IL
  • NPI 1295062594

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1932652567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 W MAIN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061953",
            "telephone_number": "800-334-5705",
            "fax_number": "888-663-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8741 S GREENWOOD AVE STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197058",
            "telephone_number": "773-779-5869",
            "fax_number": "773-779-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD ORTHOTIC & PROSTHETIC LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-01",
        "last_updated": "2025-09-02",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "MICKELSON",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGER OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "309-285-7752"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": "211000147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Comprehensive Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Chicago, IL
• Providers in Chicago, IL by specialty
• Prosthetic/Orthotic Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.