DR. KELLY L KLEIN (NPI# 1376775262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376775262 |
| Entity Type | Individual |
| Full Name | DR. KELLY L KLEIN |
| Credential | O.D. |
| Practice Address |
511 Palmyra Street Ksb Eye & Vision Care Dixon IL 61021 |
| Practice Telephone | 8152842020 |
| Practice Fax Number | 8152848326 |
| Mailing Telephone | 8152842020 |
| Mailing Fax Number | 8152848326 |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2018-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046-010280 | IL | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | 046010280 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE | F400136585 | 01 |
| IL | 046010280 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253605 | Kelly Ann Klein | Physician Assistant | 6708 River Bend Rd, Fort Worth, TX 76132-1108 | 2019-09-05 |
| 1477519114 | Kelly M Klein | Specialist/Technologist | 1215 Wilbraham Rd, Springfield, MA 01119-2654 | 2006-04-21 |
| 1316580103 | Kelly Klein | Psychologist | 940 Belmont St Bldg 2, Brockton, MA 02301-5596 | 2019-10-23 |
| 1861828832 | Kelly Leigh Klein | Registered Nurse | 5111 N Scottsdale Rd Ste 203, Scottsdale, AZ 85250-7077 | 2013-09-22 |
| 1407296882 | Kelly Anne Klein | Physician Assistant | 581 Leroy George Dr, Suite 300, Clyde, NC 28721-8084 | 2013-06-28 |
| 1376500447 | Kelly Klein | Family Medicine | 3601 4th St, Ms 8143, Lubbock, TX 79430-0002 | 2006-05-01 |
| 1659338010 | Kelly Ruthanne Klein | Emergency Medicine | 489 State St, Bangor, ME 04401-6616 | 2006-04-28 |
| Street Address |
511 PALMYRA STREET KSB EYE & VISION CARE |
| City | DIXON |
| State | IL |
| Zip Code | 61021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| 1548484769 | Rebecka D Brinkmann | Physical Therapy Assistant | 215 East 1st St, Suite 318, Dixon, IL 61021 | 2007-04-11 |
| Find all providers in zip 61021 | ||||
| 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 |
|---|---|---|---|---|
| 1285792093 | Kurt Kenneth Nelson | Optometrist | 629 N Galena Ave, Dixon, IL 61021-1664 | 2006-12-05 |
| 1760415996 | Tara K Keesey | Optometrist | 1713 Forest Hills Dr, Dixon, IL 61021-9196 | 2006-07-09 |
| 1649629072 | Peter John Popovich | Optometrist | 511 Palmyra St, Dixon, IL 61021-1953 | 2016-06-07 |
| 1750761458 | Emily S Richardson | Optometrist | 511 Palmyra St, Dixon, IL 61021 | 2015-06-08 |
| 1821323585 | Carrie Ann Menet | Optometrist | 1321 N Galena Ave, Dixon, IL 61021-1009 | 2009-10-13 |
| 1548313901 | Dixon Eyecare Associates An Optometric Corporation | Optometrist | 125 N Lincoln St, Suite A, Dixon, CA 95620-3258 | 2007-01-19 |
| 1174603997 | John Gilliland Rosten | Optometrist | 125 N Lincoln St, Suite A, Dixon, CA 95620-3258 | 2006-10-16 |
| 1164539821 | Thomas Kenneth Bialecke | Optometrist | 1350 N Galena Ave, Dixon, IL 61021 | 2006-08-25 |
| 1609832153 | Sylvia V. Rimbergas | Optometrist | 102 S Hennepin Ave, Dixon, IL 61021-3083 | 2006-04-25 |
| 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.