Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MD Orthotic and Prosthetic Laboratory, Inc

Organization Prosthetic/Orthotic Supplier · NPI 1881746758

MD Orthotic and Prosthetic Laboratory, Inc is a Prosthetic/Orthotic Supplier in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4801 W Peterson Ave Ste 402
Chicago, IL 60646
Phone: (773) 545-6047
Fax: (888) 635-3135
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X · Licence 060008643213000063 (IL)

Record details

NPI number1881746758
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Goertzen — President · (309) 676-2276
NPI enumeratedJanuary 18, 2007
Last updated in NPPESAugust 5, 2020
Certification dateAugust 5, 2020
Mailing address741 W Main St, Peoria, IL 61606-1953

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