QUAD CITY PROSTHETIC INC (NPI# 1952634982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952634982 |
Entity Type | Organization |
Organization Name | QUAD CITY PROSTHETIC INC |
Practice Address |
1222 Shooting Park Rd #104 Peru IL 61354 |
Mailing Address |
741 W Main St Peoria IL 61606-1953 |
Practice Telephone | 8152231781 |
Practice Fax Number | 8152231787 |
Mailing Telephone | 8003345705 |
Mailing Fax Number | 8886636322 |
Enumeration Date | 2009-09-09 |
Last Update Date | 2018-07-30 |
Authorized Official Name | MR. DONALD GOERTZEN (PRESIDENT) |
Authorized Official Telephone | 3096762276 |
Authorized Official Credential | CPO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578794624 | Quad City Prosthetic Inc | Durable Medical Equipment & Medical Supplies | 2207 E 52nd St, Ste 1, Davenport, IA 52807 | 2009-08-06 |
1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
1215925805 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 4730 44th St, Rock Island, IL 61201 | 2005-10-09 |
1194058123 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 520 Valley View Dr, Ste 500, Moline, IL 61265 | 2009-09-09 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Iowa Business Entities | QUAD CITY PROSTHETIC INC. | 741 West Main Street, Peoria, IL 61606 |
Street Address |
1222 SHOOTING PARK RD #104 |
City | PERU |
State | IL |
Zip Code | 61354 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922534148 | Chicago Hearing LLC | Hearing Aid Equipment | 1222 Shooting Park Rd, Peru, IL 61354-1882 | 2017-05-08 |
1639459415 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 1222 Shooting Park Rd, #104, Peru, IL 61354 | 2011-08-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
1205469483 | Illinois Valley Community Hospital | Registered Nurse | 1403 Sixth Street, Peru, IL 61354 | 2020-02-17 |
1689228322 | Zhong Xue | Dentist | 5301 Il-251, Ste A, Peru, IL 61354 | 2019-07-31 |
1003281668 | Christopher Shane Smith | Physical Therapist | 1400 Midtown Road, Peru, IL 61354 | 2015-12-08 |
1770823197 | Muscle Pain Clinic Inc | Chiropractor | 4231 Progress Blvd Ste 4, Peru, IL 61354 | 2013-02-21 |
1306194451 | Vijaya Lakshmi Bathina | Dentist | 5301 Route 251, Peru, IL 61354 | 2012-08-21 |
1225305634 | Walgreens | Point of Service | 1033 Shooting Park Road, Peru, IL 61354 | 2011-11-30 |
1811293574 | Charles Riva | Physical Therapist | 4461 N. Progress Blvd., Peru, IL 61354 | 2011-01-28 |
1932403896 | Emerging Vision, Inc | Eyewear Supplier (Equipment, not the service) | 3940 Route 251, Peru Mall Suite F-1, Peru, IL 61354 | 2011-01-06 |
1457668170 | Illinois Valley Community Hospital | Nurse Practitioner | 5307 Route 251, Peru, IL 61354 | 2010-09-01 |
Find all providers in zip 61354 |
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 |
---|---|---|---|---|
1760630644 | Girlfriends, LLC | Prosthetic/Orthotic Supplier | 4419 Progress Blvd, Peru, IL 61354-1109 | 2008-09-04 |
1639459415 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 1222 Shooting Park Rd, #104, Peru, IL 61354 | 2011-08-24 |
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 |
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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.