Provider Demographics
NPI:1962486688
Name:ORTHOGO P C
Entity Type:Organization
Organization Name:ORTHOGO P C
Other - Org Name:ORTHOGO PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:815-344-9727
Mailing Address - Street 1:4151 W ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-3973
Mailing Address - Country:US
Mailing Address - Phone:815-344-9727
Mailing Address - Fax:815-344-9728
Practice Address - Street 1:4151 W ORLEANS ST
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-3973
Practice Address - Country:US
Practice Address - Phone:815-344-9727
Practice Address - Fax:815-344-9728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210955Medicare ID - Type UnspecifiedMC OPT ID