| Dr Kaitlyn Renae Gibson, OD | |
|
13115 Wicker Ave Ste E, Cedar Lake, IN 46303-7400 | |
| (219) 374-7800 | |
| (219) 374-5196 |
| Full Name | Dr Kaitlyn Renae Gibson |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 13115 Wicker Ave Ste E, Cedar Lake, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992319719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 18004243A (Indiana) | Primary |
| Provider Name | Illiana Eyecare Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1215040142 PECOS PAC ID: 9133223373 Enrollment ID: O20070328000572 |
| Provider Name | Region Eye Care Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1043717945 PECOS PAC ID: 0648521203 Enrollment ID: O20180920000577 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kaitlyn Renae Gibson, OD 13115 Wicker Ave Ste E, Cedar Lake, IN 46303-7400 Ph: (219) 374-7800 | Dr Kaitlyn Renae Gibson, OD 13115 Wicker Ave Ste E, Cedar Lake, IN 46303-7400 Ph: (219) 374-7800 |
Kossis Eyecare Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 9849 Lincoln Plaza Way, Cedar Lake, IN 46303 Phone: 216-789-9066 | |
Illiana Eyecare Inc Optometrist Medicare: Medicare Enrolled Practice Location: 13115 Wicker Avenue, Suite E, Cedar Lake, IN 46303 Phone: 219-374-7800 | |
Mrs. Brittany Rae Disterheft, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 13115 Wicker Ave Ste E, Cedar Lake, IN 46303 Phone: 219-374-7800 Fax: 219-374-5196 |