CLARKSON OPTOMETRY ILLINOIS PC (NPI# 1508083502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508083502 |
| Entity Type | Organization |
| Organization Name | CLARKSON OPTOMETRY ILLINOIS PC |
| Practice Address |
1025 Columbia Ctr Columbia IL 62236-2546 |
| Mailing Address |
Po Box 207163 Dallas TX 75320-7154 |
| Practice Telephone | 6362004393 |
| Practice Fax Number | 6182813927 |
| Mailing Telephone | 6362004393 |
| Mailing Fax Number | 6365270766 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2019-06-21 |
| 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 | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DMERC | 0360070027 | 01 |
| 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 |
| 1952595878 | Clarkson Optometry Illinois PC | Optometrist | 210 S Main, Red Bud, IL 62278 | 2007-09-04 |
| 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 |
| 1457303125 | Clarkson Optometry Illinois PC | Optometrist | 3248 Green Mount Crossing Dr, Shiloh, IL 62269-7284 | 2006-05-17 |
| Street Address |
1025 COLUMBIA CTR |
| City | COLUMBIA |
| State | IL |
| Zip Code | 62236-2546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578533410 | James D Hollmann | Optometrist | 1025 Columbia Ctr, Columbia, IL 62236-2546 | 2006-01-24 |
| 1003875147 | Jason Richard Diehl | Optometrist | 1025 Columbia Ctr, Columbia, IL 62236-2546 | 2006-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962937300 | Assoicated Physicians Group Ltd | Nurse Practitioner | 1011 South, Suite 3b, Columbia, IL 62236 | 2017-04-24 |
| 1316284854 | Robert Siekerka | Pharmacist | 1412 N Evergreen Ln, Columbia, IL 62236 | 2013-01-03 |
| 1972874352 | Jennifer Harlin Wilhelm | Veterinarian | 1400 Columbia Center Drive, Bellson Animal Hospital, Columbia, IL 62236 | 2012-01-18 |
| 1912275314 | Synergy Therapeutics, PC | Dentist | 1000 Eleven South, Suite 3f, Columbia, IL 62236 | 2011-12-13 |
| 1134455991 | Julie Williams | Skilled Nursing Facility | 3 Eagle Crest Court, Columbia, IL 62236 | 2009-10-28 |
| 1831311158 | Lifetime Dental Care of Illinois, PC | Dentist | 240 Southwoods Centre Drive, Columbia, IL 62236 | 2007-05-03 |
| 1730301268 | Affordable Dentistry Today, PC | Dentist | 242 Southwoods Centre Drive, Columbia, IL 62236 | 2007-05-03 |
| 1710109616 | Jason Clay King | Chiropractor | 117 West Cedar Street, Columbia, IL 62236 | 2007-05-02 |
| 1184704900 | Mitan Pediatric Therapy Inc | Occupational Therapist | 891 Meadowview Lane, Columbia, IL 62236 | 2006-10-16 |
| 1265528368 | Kathryn Ann Mager | Counselor | 9273 Coach Stop Road, Columbia, IL 62236 | 2006-10-05 |
| Find all providers in zip 62236 | ||||
| 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 |
|---|---|---|---|---|
| 1447876040 | Rachel Cho | Optometrist | 8900 Columbia 100 Pkwy Ste L, Columbia, MD 21045-2336 | 2020-06-19 |
| 1982232922 | Katzen Medical Associates | Optometrist | 6325 Woodside Ct Ste 125, Columbia, MD 21046-3215 | 2020-03-27 |
| 1972135754 | Healthy Eyes Vision Group LLC | Optometrist | 1518 Pickens St, Columbia, SC 29201-3449 | 2020-02-10 |
| 1699257881 | Henry Gates | Optometrist | 1 Fort Jackson, Columbia, SC 29207-5000 | 2018-09-04 |
| 1316443146 | Eyes On The Lake LLC | Optometrist | 2914 Dreher Shoals Rd Ste A, Columbia, SC 29212-7909 | 2018-04-02 |
| 1356861025 | Lindsey Vallejo | Optometrist | 816 S James Campbell Boulevard, Columbia, TN 38401 | 2017-06-23 |
| 1639607930 | Valerie L. Gallo | Optometrist | 201 Harbison Blvd Ste 110, Columbia, SC 29212-2270 | 2017-05-31 |
| 1578001293 | Daniel & Max, LLC | Optometrist | 10110 Two Notch Rd, Columbia, SC 29223-4383 | 2017-02-01 |
| 1669832812 | Hirangi Patel | Optometrist | 4601 Forest Dr Ste C, Columbia, SC 29206-3122 | 2016-03-01 |
| 1801256466 | Myeyedr Optometry of Maryland, LLC | Optometrist | 6110a Dobbin Rd, Columbia, MD 21045-5843 | 2016-02-25 |
| Find all providers in COLUMBIA | ||||
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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.