Clarkson Optometry Illinois PC
Optometrist · Breese, IL
Practice location
103 Clintonian PlazaBreese, IL 62230
- Phone
- (636) 200-4393
- Fax
- (618) 526-7455
NPI record
- NPI
- 1063606978
- Entity type
- Organization (Type 2)
- Enumeration date
- September 4, 2007
- Last updated
- June 21, 2019
- Organization subpart
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X |
036104178 | IL |
Mailing address
PO Box 207163Dallas, TX 75320-7154
- Phone
- (636) 200-4393
- Fax
- (636) 527-0766
Authorized official
- Name
- Dr. James J Wachter, OD
- Title
- CMO
- Phone
- (636) 200-4393
Other names
- Clarkson Eyecare
About Clarkson Optometry Illinois PC
Clarkson Optometry Illinois PC is a healthcare organization registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 103 Clintonian Plaza, Breese, IL 62230. The NPI number 1063606978 was assigned on September 4, 2007 and the record was last updated on June 21, 2019.
Clarkson Optometry Illinois PC lists a license in the registry: #036104178 (IL) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.
The authorized official for this organization is Dr. James J Wachter, OD, CMO.
Frequently asked questions
What is the NPI number of Clarkson Optometry Illinois PC?
The NPI number is 1063606978.
What is the phone number of Clarkson Optometry Illinois PC?
The phone number listed for the practice location is (636) 200-4393.
Where is Clarkson Optometry Illinois PC located?
103 Clintonian Plaza, Breese, IL 62230.
What is the taxonomy code for Clarkson Optometry Illinois PC?
The primary taxonomy code is 152W00000X – Optometrist.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.