NPIMap

Organization Active NPI

Clarkson Optometry Illinois PC

Doing business as Clarkson Eyecare

  • Optometrist
  • Swansea, IL
National Provider Identifier
1548664634
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010533 Issued in IL
Legal business name
CLARKSON OPTOMETRY ILLINOIS PC
Doing business as
Clarkson Eyecare
Practice address
2645 N Illinois St
Swansea, IL 62226-2302
Phone
(636) 200-4393
Fax
(618) 767-5101
NPI assigned
Oct 17, 2014
Last updated
Jun 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James WachterNPI 1689670697
Title
Owner
Phone
(636) 200-4393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010533 IL Primary

Addresses

Primary practice location

2645 N Illinois St
Swansea, IL 62226-2302

Mailing address

PO Box 207163
Dallas, TX 75320-7154
Phone (636) 200-4393

Other names 1

  • Clarkson Eyecare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clarkson Eyecare15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1548664634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207163",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207154",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 N ILLINOIS ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262302",
            "telephone_number": "636-200-4393",
            "fax_number": "618-767-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkson Eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarkson Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.