Provider Demographics
NPI: | 1083174064 |
---|---|
Name: | SCHECK & SIRESS PROSTHETICS, INC |
Entity Type: | Organization |
Organization Name: | SCHECK & SIRESS PROSTHETICS, INC |
Other - Org Name: | HANGER CLINIC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PROVIDER CONTRACT ANALYST III |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GRACE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ANGELINE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 714-961-2102 |
Mailing Address - Street 1: | PO BOX 650846 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75265-0846 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 233 E ERIE ST STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | CHICAGO |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60611-5938 |
Practice Address - Country: | US |
Practice Address - Phone: | 312-787-4400 |
Practice Address - Fax: | 312-787-4402 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-03-25 |
Last Update Date: | 2023-12-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 335E00000X | Suppliers | Prosthetic/Orthotic Supplier | |
No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |