Individual
DR. MARK A KLEINDORFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1801 PONTOON RD, GRANITE CITY, IL 62040-2338
(618) 931-2700
(618) 931-2747
Mailing address
1801 PONTOON RD, GRANITE CITY, IL 62040-2338
(618) 931-2700
(618) 931-2747
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-7202
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046-7202
STATE LICENSE
IL
Enumeration date
04/27/2006
Last updated
03/07/2023
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