OrganizationActive
Custom Brace Shop Inc.
NPI 1306865563 · Durable Medical Equipment & Medical Supplies · Galesburg, IL
Provider details
- NPI number
- 1306865563
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Fakhry Azer, President /Owner(309) 344-3400
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
872 W Dayton St
Galesburg, IL 61401-1503
Phone: (309) 344-5330
Fax: (309) 344-5040
Street-level locationGet directions
Mailing address
872 W Dayton St
Galesburg, IL 61401-1503
Registry dates
- Enumerated
- 2006-07-19
- Last updated
- 2008-07-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.