CLARKSON OPTOMETRY ILLINOIS PC (NPI# 1669668836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669668836 |
| Entity Type | Organization |
| Organization Name | CLARKSON OPTOMETRY ILLINOIS PC |
| Practice Address |
6663 Edwardsville Crossing Dr Edwardsville IL 62025-2704 |
| Mailing Address |
Po Box 207163 Dallas TX 75320-7154 |
| Practice Telephone | 6362004393 |
| Practice Fax Number | 6186550375 |
| Mailing Telephone | 6362004393 |
| Mailing Fax Number | 6365270766 |
| Enumeration Date | 2007-09-20 |
| 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 | 0046.009944 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DMERC | 0360070028 | 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 |
| 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 |
6663 EDWARDSVILLE CROSSING DR |
| City | EDWARDSVILLE |
| State | IL |
| Zip Code | 62025-2704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932199585 | Chad Baker | Optometrist | 6663 Edwardsville Crossing Dr, Edwardsville, IL 62025-2704 | 2005-10-25 |
| 1306125166 | Mark A Havera | Optometrist | 6663 Edwardsville Crossing Dr, Ste B, Edwardsville, IL 62025-2704 | 2011-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619519535 | Anderson Surgery Center LLC | Clinic/Center | 3403 Anderson Healthcare Drive, Edwardsville, IL 62025 | 2019-10-11 |
| 1194376640 | Katharine Mcginnis D.m.d. P.C. | Dentist | 235 A. South Main St, Edwardsville, IL 62025 | 2019-09-26 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1902277031 | Amy Lynn Britt | Nurse Practitioner | 1188 South State Route 157, Edwardsville, IL 62025 | 2015-10-15 |
| 1730563230 | Jenna Dallman | Chiropractor | 3 Sunset Hills Professional Center, Suite 2, Edwardsville, IL 62025 | 2015-07-14 |
| 1861745218 | Srimannarayana Marella | Family Medicine | 6616 Center Grove Rd., Edwardsville, IL 62025 | 2012-10-23 |
| 1669722872 | Ican Clinic LLC | Chiropractor | 441 S State Route 157 Ste 2, Edwardsville, IL 62025 | 2012-09-14 |
| 1922371673 | Teresa Marie Garbett | Pharmacist | 2 Sunset Hills Executive Park Dr., Addiction Treatment Strategies, Edwardsville, IL 62025 | 2012-02-10 |
| 1831324342 | Krista Nicole Nelson | Podiatrist | 235 S Main St Ste B, Edwardsville, IL 62025 | 2009-05-28 |
| 1447415757 | Harvey H Breckner D.m.d.,m.s | Exclusive Provider Organization | 600 Country Club View Suite 4, Edwardsville, IL 62025 | 2008-07-25 |
| Find all providers in zip 62025 | ||||
| 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 |
|---|---|---|---|---|
| 1902127459 | Montclaire Eye Associates | Optometrist | 1514 Troy Rd Ste C, Edwardsville, IL 62025-2597 | 2010-06-18 |
| 1245476357 | Suman Dilip Navalgund | Optometrist | 1950 Edwardsville Club Plaza Ct, Edwardsville, IL 62025-3717 | 2008-12-18 |
| 1477703411 | Christina J. Levi O D P C | Optometrist | 2100 Troy Rd, Edwardsville, IL 62025-2595 | 2008-09-26 |
| 1598953994 | Metro Eye Care PC | Optometrist | 6620 Center Grove Rd, Suite 3, Edwardsville, IL 62025-2802 | 2007-10-10 |
| 1033261904 | Christina J. Levi O D,p C | Optometrist | 2100 Troy Rd Ste 104, Edwardsville, IL 62025-2595 | 2007-01-18 |
| 1013965367 | Stephanie R Goggin | Optometrist | 6620 Center Grove Road, Edwardsville, IL 62025-2802 | 2006-05-05 |
| 1932199585 | Chad Baker | Optometrist | 6663 Edwardsville Crossing Dr, Edwardsville, IL 62025-2704 | 2005-10-25 |
| 1982602918 | John Robert Eigenbrodt | Optometrist | 1950 Edwardsville Club Plaza, Edwardsville, IL 62025-3517 | 2005-07-13 |
| 1639732431 | Vep Il Optometric LLC | Optometrist | 6679 Center Grove Rd, Edwardsville, IL 62025-2803 | 2019-04-17 |
| 1235519190 | Natalie J. Carr | Optometrist | 2100 Troy Rd, Edwardsville, IL 62025-2595 | 2015-06-05 |
| Find all providers in EDWARDSVILLE | ||||
| City | EDWARDSVILLE |
| Zip Code | 62025 |
Please comment or provide details below to improve the information on CLARKSON OPTOMETRY ILLINOIS PC.
| 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.