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Contact Information

KELLY L KLEIN, OD
511 PALMYRA STREET
KSB EYE & VISION CARE
DIXON, IL61021
 Phone: 815-284-2020
 Fax: 815-284-8326
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KELLY L KLEIN · (Female)

NPI Number 1376775262
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 08/11/2009
Last updated 08/23/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 046-010280
  • IL License # 046010280
  • IL Medicaid 046010280
  • IL Other F400136585 MEDICARE
Hospital affiliation(s)
  • KATHERINE SHAW BETHEA HOSPITAL - (Acute Care)
    403 E 1ST ST
    DIXON, IL 61021
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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