Lawrence Gordon Soellner, OD
Individual provider Active NPI Optometrist · Chester, IL
NPI 1073595005 · NPPES record last updated Feb 22, 2008
Key facts
- NPI
- 1073595005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- Practice address
- 425 W Holmes St
Chester, IL 62233-1331 - Phone
- (618) 826-4521
- Fax
- (618) 826-4520
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern Illinois Eyecare PLLC
Practice addresses (Care Compare)
630 S Washington St
Du Quoin, IL 62832-1906
Phone (618) 542-6677
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 41 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050418000251 | IL | Practitioner - Optometry | 7113975384 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Eyecare PLLC | Optometrist | Current |
Accepting new patients |
| Southern Illinois Eyecare PLLC | Optometrist | Current |
Accepting new patients |
| JFJ Eyecare LTD | Optometrist | Past | Accepting new patients |
Locations
425 W Holmes St
Chester, IL 62233
Phone (618) 826-4521
1209 Swanwick St
Chester, IL 62233
Phone (618) 826-4521
630 S Washington St
Du Quoin, IL 62832
Phone (618) 542-6677
521 N Borders Ave
Ste B
Marissa, IL 62257
Phone (618) 295-1600
15 N Locust St
Pinckneyville, IL 62274
Phone (618) 357-6117
520 E Broadway St
Sparta, IL 62286
Phone (618) 443-3111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Yes |
Addresses
Primary practice location
425 W Holmes St
Chester, IL 62233-1331
Mailing address
425 W Holmes St
Chester, IL 62233-1331
Phone (618) 826-4521
Other providers in Chester, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.