OrganizationActive
Form Orthotics & Prosthetics, PLLC
NPI 1740113422 · Prosthetic/Orthotic Supplier · Rockford, IL
Form Orthotics & Prosthetics, PLLC is a Prosthetic/Orthotic Supplier organization in Rockford, IL (NPI 1740113422).
Provider details
- NPI number
- 1740113422
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Micah Alford, Founder(402) 212-7878
Specialties & taxonomies
Suppliers
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
4921 E State St Lowr Level
Rockford, IL 61108-2275
Phone: (402) 212-7878
Street-level locationGet directions
Mailing address
4921 E State St Lowr Level
Rockford, IL 61108-2275
Registry dates
- Enumerated
- 2026-06-04
- Last updated
- 2026-06-04
- Certified
- 2026-06-04
Frequently asked questions
- What is Form Orthotics & Prosthetics, PLLC's NPI number?
- Form Orthotics & Prosthetics, PLLC's National Provider Identifier (NPI) is 1740113422, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Form Orthotics & Prosthetics, PLLC?
- Form Orthotics & Prosthetics, PLLC is classified in the NPPES registry as Prosthetic/Orthotic Supplier (Suppliers).
- Where is Form Orthotics & Prosthetics, PLLC located?
- Form Orthotics & Prosthetics, PLLC's practice location on file with NPPES is 4921 E State St Lowr Level, Rockford, IL 61108-2275.
- What is Form Orthotics & Prosthetics, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Form Orthotics & Prosthetics, PLLC is (402) 212-7878.
- Who is the authorized official for Form Orthotics & Prosthetics, PLLC?
- The authorized official listed on Form Orthotics & Prosthetics, PLLC's NPPES record is Micah Alford, Founder. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Form Orthotics & Prosthetics, PLLC's NPI active?
- Yes — Form Orthotics & Prosthetics, PLLC's NPI (1740113422) is active in the NPPES registry as of the last update on 2026-06-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.