Organization
CLARKSON OPTOMETRY ILLINOIS, P.C.
Active
Other names
Clarkson Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WACHTER (CMO)
(636) 200-4393
Entity
Organization
Contact information
Practice address
1310 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1685
(636) 200-4393
(618) 467-1053
Mailing address
PO BOX 207163, DALLAS, TX 75320-7154
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
036058812
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
IL
Other
Enumeration date
07/28/2011
Last updated
06/04/2019
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