Provider Demographics
NPI:1932347887
Name:WOODFIELD ORTHOTICS & PROSTHETICS, LLC
Entity type:Organization
Organization Name:WOODFIELD ORTHOTICS & PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:847-382-3222
Mailing Address - Street 1:12380 PRINCETON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-7655
Mailing Address - Country:US
Mailing Address - Phone:847-961-5800
Mailing Address - Fax:847-961-5801
Practice Address - Street 1:12380 PRINCETON DR
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-7655
Practice Address - Country:US
Practice Address - Phone:847-961-5800
Practice Address - Fax:847-961-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCPO 1980332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment