SRT PROSTHETICS & ORTHOTICS LLC (NPI# 1851409932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851409932 |
| Entity Type | Organization |
| Organization Name | SRT PROSTHETICS & ORTHOTICS LLC |
| Practice Address |
6475 Washington St. Suite 100 Gurnee IL 60031 |
| Mailing Address |
408 E Washington St Butler IN 46721-1179 |
| Practice Telephone | 8478550030 |
| Practice Fax Number | 4196333961 |
| Mailing Telephone | 4196333961 |
| Mailing Fax Number | 4196333981 |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2019-02-18 |
| Authorized Official Name | LESLIE SIEBENALER (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8666333961 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | IL | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841698834 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 5220 S 27th St., Milwaukee, WI 53221 | 2014-12-08 |
| 1255681870 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 618 N High School Rd Ste B, Indianapolis, IN 46214-3684 | 2012-09-11 |
| 1295000909 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 1900 N Meridian St, Indianapolis, IN 46202-1304 | 2012-03-13 |
| 1497929434 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 406 N. Front St., Suite F, Mchenry, IL 60050 | 2008-04-22 |
| 1508804295 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 4109 W Jefferson Blvd, Ft Wayne, IN 46804-6894 | 2006-06-03 |
| 1699712695 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 217 E Southway Blvd Ste 100, Kokomo, IN 46902-3577 | 2006-05-31 |
| 1245222785 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 408 E Washington St, Butler, IN 46721-1179 | 2005-08-19 |
| 1902156532 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 8936 Southpointe Dr, Suite B-1, Indianapolis, IN 46227-7507 | 2012-09-11 |
| 1134417009 | Srt Prosthetics & Orthotics LLC | Prosthetic/Orthotic Supplier | 3301 W Bethel Ave, Muncie, IN 47304-5402 | 2011-07-13 |
| Street Address |
6475 WASHINGTON ST. SUITE 100 |
| City | GURNEE |
| State | IL |
| Zip Code | 60031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| 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 |
|---|---|---|---|---|
| 1366974206 | Kelly Reid-krueger | Prosthetic/Orthotic Supplier | 6475 Washington St Ste 100, Gurnee, IL 60031-4404 | 2017-03-30 |
| 1437681384 | Erin Ruxton | Prosthetic/Orthotic Supplier | 6475 Washington St Ste 100, Gurnee, IL 60031-4404 | 2017-03-30 |
| 1881044519 | Reichert Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 15 Tower Ct, Suite 245, Gurnee, IL 60031-3336 | 2016-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909517 | Matayah Love | Prosthetic/Orthotic Supplier | 5833 W Madison St, Chicago, IL 60644-3840 | 2020-10-15 |
| 1225653686 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1290 W Northwest Hwy, Palatine, IL 60067-1897 | 2020-06-11 |
| 1710508239 | Vivian Danielle Williams | Prosthetic/Orthotic Supplier | 940 N Monticello Ave # 1, Chicago, IL 60651-3949 | 2020-05-06 |
| 1265053136 | Dfined Beauty LLC | Prosthetic/Orthotic Supplier | 1507 E 53rd St # 835, Chicago, IL 60615-4573 | 2020-05-02 |
| 1134748767 | The Weave Luxe Bar | Prosthetic/Orthotic Supplier | 7315 Lemont Rd, Downers Grove, IL 60516-3807 | 2020-04-14 |
| 1245865245 | Ortheco LLC | Prosthetic/Orthotic Supplier | 3050 Montvale Dr Ste E, Springfield, IL 62704-4290 | 2020-03-10 |
| 1417515784 | Dionne Williams Group | Prosthetic/Orthotic Supplier | 6822 S Wood St, Chicago, IL 60636-3337 | 2019-06-03 |
| 1164080743 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 391 Quadrangle Dr Ste N4, Bolingbrook, IL 60440-3443 | 2019-05-30 |
| 1760047583 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 13500 Circle Dr Ste 202, Orland Park, IL 60462-1343 | 2019-05-07 |
| 1114580107 | Thomas Gavin | Prosthetic/Orthotic Supplier | 1010 Jorie Blvd Ste 24, Oak Brook, IL 60523-4450 | 2019-04-16 |
| Find all providers with the same taxonomy | ||||
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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.