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CUSTOM BRACE SHOP INC.
NPI 1306865563
Durable Medical Equipment & Medical Supplies in Galesburg, IL

Active since July 19, 2006
872 W DAYTON ST, GALESBURG, IL 61401(309) 344-5330(309) 344-5040 Get Directions Write a Review

NPPES record last updated: July 11, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Custom Brace Shop Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOM BRACE SHOP INC. (NPI 1306865563) is a healthcare organization registered as a durable medical equipment & medical supplies in Galesburg, Illinois and active in the NPI registry since July 2006. The organization lists Fakhry Wilson Azer, President /owner, as its authorized official.

NPPES Registry Identity

NPI1306865563
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameCUSTOM BRACE SHOP INC.
Location Address872 W DAYTON STGalesburg, IL 61401-1503
Mailing Address872 W Dayton StGalesburg, IL 61401-1503 · (309) 344-5330 · Fax (309) 344-5040
Phone(309) 344-5330
Fax(309) 344-5040
Organization SubpartNo
Authorized OfficialFakhry Wilson AzerPresident /owner · (309) 344-3400
Enumeration DateJuly 19, 2006
Last NPPES UpdateJuly 11, 2008
✔ NPI 1306865563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
872 W DAYTON ST, Galesburg, IL 61401
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Other Identifiers 2

Other30404878IL · Certificate Of Registrati
Medicare NSC1284320001IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AZER REHAB SYSTEMS, P.C.
Clinic/Center (Rehabilitation)
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400
MS. MELISSA ENGEBRETSON P.T.
Physical Therapist
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400
SUSAN LATTA OT
Occupational Therapist
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400
TRISHA HANSON SLP
Speech-Language Pathologist
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400
HANNAH EMERY SLP
Speech-Language Pathologist
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400
JAMIE HAYNES PT
Physical Therapist
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400
MR. PATRICK SMITH P.T.
Physical Therapist
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400
MS. CAITLIN CLARE SMITH OT
Occupational Therapist
872 W DAYTON ST
GALESBURG, IL 61401
Knox County (309) 344-3400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Brace Shop Inc.'s NPI number?

The NPI number for Custom Brace Shop Inc. is 1306865563. It was assigned to this organization in the NPPES registry on July 19, 2006.

Where is Custom Brace Shop Inc. located?

Custom Brace Shop Inc. is located at 872 W Dayton St, Galesburg, IL 61401. The listed phone number is (309) 344-5330.

What is Custom Brace Shop Inc.'s specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Custom Brace Shop Inc. was last updated on July 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.