National Provider Identifier Database

CLARKSON OPTOMETRY ILLINOIS PC
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.


Contact Information

CLARKSON OPTOMETRY ILLINOIS PC
204 BRADFORD LANE
WATERLOO, IL62298
Phone: 636-200-4393
Fax: 618-939-6037
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for CLARKSON OPTOMETRY ILLINOIS PC

NPI Number 1649464553
Legal business name
LBN
CLARKSON OPTOMETRY ILLINOIS PC
Authorized official JAMES WACHTER - (CMO)
Entity Organization
Organization subpart No
Enumeration date 09/04/2007
Last updated 06/21/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 036104178
  • IL Medicaid: 036104178

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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