CLARKSON OPTOMETRY ILLINOIS PC (NPI# 1952595878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952595878 |
| Entity Type | Organization |
| Organization Name | CLARKSON OPTOMETRY ILLINOIS PC |
| Other Organization Name | CLARKSON EYECARE |
| Practice Address |
210 S Main Red Bud IL 62278 |
| Mailing Address |
15933 Clayton Rd Ste 201 Ballwin MO 63011-2172 |
| Practice Telephone | 6186353535 |
| Practice Fax Number | 6182822830 |
| Mailing Telephone | 6362004393 |
| Mailing Fax Number | 6365270766 |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2018-01-31 |
| Authorized Official Name | DR. JAMES J WACHTER (CMO) |
| Authorized Official Telephone | 6362004393 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 046008176 | 05 | |
| IL | 0460089501 | 05 | |
| IL | 0460069901 | 05 | |
| PTAN | 203195 | 01 | |
| IL | 036104178 | 05 | |
| IL | 046006474 | 05 | |
| PTAN | 203193 | 01 | |
| IL | 0460078192 | 05 | |
| IL | 0460085471 | 05 | |
| IL | 0460089082 | 05 | |
| PTAN | 203194 | 01 |
| Other Name | Type Code |
|---|---|
| Clarkson Eyecare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578806378 | Clarkson Optometry Illinois PC | Optometrist | 208 West Main, Staunton, IL 62088-1470 | 2013-03-29 |
| 1124214051 | Clarkson Optometry Illinois PC | Optometrist | 2525 Green Mount Crossing Dr., Suite 290, Belleville, IL 62221-6735 | 2007-09-25 |
| 1649464553 | Clarkson Optometry Illinois PC | Optometrist | 204 Bradford Lane, Waterloo, IL 62298 | 2007-09-04 |
| 1063606978 | Clarkson Optometry Illinois PC | Optometrist | 103 Clintonian Plaza, Breese, IL 62230 | 2007-09-04 |
| 1982898375 | Clarkson Optometry Illinois PC | Optometrist | 3000 Broadway St, Mount Vernon, IL 62864-2340 | 2007-08-29 |
| 1548664634 | Clarkson Optometry Illinois PC | Optometrist | 2645 N Illinois St, Swansea, IL 62226-2302 | 2014-10-17 |
| 1669668836 | Clarkson Optometry Illinois PC | Optometrist | 6663 Edwardsville Crossing Dr, Edwardsville, IL 62025-2704 | 2007-09-20 |
| 1508083502 | Clarkson Optometry Illinois PC | Optometrist | 1025 Columbia Ctr, Columbia, IL 62236-2546 | 2007-04-19 |
| 1457303125 | Clarkson Optometry Illinois PC | Optometrist | 3248 Green Mount Crossing Dr, Shiloh, IL 62269-7284 | 2006-05-17 |
| Street Address |
210 S MAIN |
| City | RED BUD |
| State | IL |
| Zip Code | 62278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477852028 | Margret De Jesus De Guzman | Surgery | Red Bud Illinois Hospital Comany LLC, 325 Spring St, Red Bud, IL 62278 | 2011-03-22 |
| 1679795157 | Human Service Center of Southern Metro East | Clinic/Center | 10257 State Route Three, Red Bud, IL 62278 | 2007-05-03 |
| 1508980798 | Quentin Thomas Stenzel | Chiropractor | 204 W. Market, Red Bud, IL 62278 | 2007-03-16 |
| 1306905054 | Jennifer Ranee Dewilde | Chiropractor | 930 West Market, Suite 1, Red Bud, IL 62278 | 2006-12-08 |
| 1588147623 | Thomas Michael Castilaw | Nurse Practitioner | 325 Spring St, Red Bud, IL 62278 | 2018-09-14 |
| 1336353523 | Human Service Center | Private Vehicle | 10257 State Route Three, Red Bud, IL 62278 | 2007-05-09 |
| 1093928111 | Human Service Center | Clinic/Center | 10257 State Route Three, Red Bud, IL 62278 | 2007-05-07 |
| 1386856409 | Human Service Center of Southern Metro East | Clinic/Center | 115 East Stacey Street, Chester, IL 62278 | 2007-05-03 |
| 1417960121 | Tina Renee Stulce | Dentist | 307 S Main St, Red Bud, IL 62278 | 2006-08-14 |
| 1417058777 | Drs Pichet & Meechai | Internal Medicine | 415 W S Fourth St, Suite A, Red Bud, IL 62278-0168 | 2006-09-26 |
| Find all providers in zip 62278 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
| 1124627880 | Biren Patel | Optometrist | 1330 N Larkin Ave, Joliet, IL 60435-3765 | 2020-10-22 |
| 1790392587 | Adriana Casillas | Optometrist | 11129 S Avenue J, Chicago, IL 60617-6910 | 2020-09-25 |
| 1033725114 | Sabrina D'haiti | Optometrist | 607 Oakton St, Evanston, IL 60202-5615 | 2020-09-23 |
| 1164037495 | Brett David Freitag | Optometrist | 5006 Northwest Hwy, Crystal Lake, IL 60014-7339 | 2020-09-14 |
| 1164036786 | Deeti Patel | Optometrist | 9053 Hollyberry Ave, Des Plaines, IL 60016-4216 | 2020-09-01 |
| 1497368252 | Gca Optical LLC | Optometrist | 1520 N Rock Run Dr Ste 2, Crest Hill, IL 60403-3172 | 2020-08-30 |
| 1538778097 | Opt Vision | Optometrist | 5371 W Lawrence Ave Ste A, Chicago, IL 60630-3695 | 2020-07-30 |
| 1578180147 | Ortizii PC | Optometrist | 111 N Wabash Ave Ste 1111, Chicago, IL 60602-3119 | 2020-06-30 |
| 1053938092 | Premier Vision Center LLC | Optometrist | 2809 Mansion Rd Ste A, Springfield, IL 62711-6811 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.