Mark A Kleindorfer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-7202 Issued in IL

Practice address

1801 Pontoon Rd
Granite City, IL 62040-2338

Phone

(618) 931-2700

Fax

(618) 931-2747

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mark.kleindorfer@direct.revolutionehr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Havera Eye Care Specialists LLC

  • Optometrist
  • Collinsville, IL
  • NPI 1942862214
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1992762413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 PONTOON RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620402338",
            "telephone_number": "618-931-2700",
            "fax_number": "618-931-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PONTOON RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620402338",
            "telephone_number": "618-931-2700",
            "fax_number": "618-931-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINDORFER",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-7202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "046-7202",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• King Spinal & Sports Rehabilitation, LTD.
• Charles E King Jr., D.C.
• Erin Lee King, M.D.
• Stephanie King, FNP-BC
• Terri Lou Klawonn, LCPC
• Kristopher Michael Klint, CRNA
• Christopher Jean Knapp, MD, MPH
• Kendall Brennan Knobeloch, RN
• Timothy J Knox, PT, CHT
• Ashleigh Ann Kohrmann

• Optometrist in Granite City, IL
• Providers in Granite City, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.