TIMOTHY W PORCELLI (NPI# 1699896431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699896431 |
| Entity Type | Individual |
| Full Name | TIMOTHY W PORCELLI |
| Credential | LCPED |
| Practice Address |
3723 N Southport Chicago IL 60613-3718 |
| Mailing Address |
Pob 13377 Chicago IL 60613 |
| Practice Telephone | 3124092175 |
| Mailing Telephone | 3124092175 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 1670909 | 01 |
| Street Address |
3723 N SOUTHPORT |
| City | CHICAGO |
| State | IL |
| Zip Code | 60613-3718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261978 | Thorek Radiology Group Nfp | Radiology | 850 West Irving Park Road, Chicago, IL 60613 | 2020-10-08 |
| 1760034128 | Maryellen Karas Lajeunesse | Social Worker | 3930 N. Pine Grove Ave, #2403, Chicago, IL 60613 | 2019-07-15 |
| 1801366430 | Stephanie A Dykema | Psychologist | 4043 N Ravenswood Ave Suite 302, Chicago, IL 60613 | 2018-11-27 |
| 1487154191 | Alan Tsang | Counselor | 655 W Irving Park Rd Ste 203, Chicago, IL 60613 | 2018-02-19 |
| 1972015782 | Integrated Ortho, LLC. | Durable Medical Equipment & Medical Supplies | 3717 N. Ravenswood Ave, Suite 219w, Chicago, IL 60613 | 2017-11-02 |
| 1073048005 | Claire Jolly | Social Worker | 3701 N Ravenswood Ave Ste 301, Chicago, IL 60613 | 2017-04-27 |
| 1730626011 | Marc Fagan | Psychologist | 4101 N Ravenswood Ave., Chicago, IL 60613 | 2017-01-25 |
| 1205385671 | Sara Turner | Psychologist | 3855 N Greenview Ave # 2a, Chicago, IL 60613 | 2016-09-27 |
| 1962955997 | Michelle Montero | Psychologist | 925 W Dakin St Apt 405, Chicago, IL 60613 | 2016-07-26 |
| 1063883494 | Athletico, Ltd | Physical Therapist | 3922 North Sheridan Rd, Chicago, IL 60613 | 2015-10-12 |
| Find all providers in zip 60613 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831691104 | Ashley Zinnamon | Orthotist | 1525 E 55th St Ste 204, Chicago, IL 60615-5512 | 2018-03-02 |
| 1306981345 | Matthew Alan Goddard | Orthotist | 2515 N Clark St Ste 802, Chicago, IL 60614-2730 | 2007-02-20 |
| 1386781755 | Andreas Josef Bohner | Orthotist | 2300 N Childrens Plz # 46, Chicago, IL 60614-3363 | 2007-02-01 |
| 1568509040 | Robert Allen Novak | Orthotist | 5521 N Cumberland Ave, Suite 1115, Chicago, IL 60656-4717 | 2007-01-31 |
| 1396371225 | Breanna Angela Baltrusch | Orthotist | 2515 N Clark St Ste 802, Chicago, IL 60614-2730 | 2020-03-23 |
| 1063062370 | Michael Socie | Orthotist | 355 E Erie St, Chicago, IL 60611-3167 | 2019-09-18 |
| 1679034177 | Sara L Jerousek | Orthotist | 225 E Chicago Ave, Chicago, IL 60611 | 2019-03-27 |
| 1083195424 | Erin Claussen | Orthotist | 225 E Chicago Ave # 46, Chicago, IL 60611-2991 | 2018-08-23 |
| 1215423843 | Sourabh Nagale | Orthotist | 2515 N Clark St, Ste 802, Chicago, IL 60614 | 2018-07-06 |
| 1447747308 | Michael Elsen | Orthotist | 1725 W Harrison St Ste 220, Chicago, IL 60612-3836 | 2018-04-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.