| Lebanon Optometric Center, Llc | |
|
201 W Saint Louis St, Lebanon, IL 62254-1515 | |
| (618) 537-6356 | |
| (618) 537-6358 |
| Full Name | Lebanon Optometric Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 201 W Saint Louis St, Lebanon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447373378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 046007516 (Illinois) | Primary |
| Provider Name | Charissa L Thorpe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740225994 PECOS PAC ID: 2466524640 Enrollment ID: I20080703000025 |
| Provider Name | Robert J Klinsky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568407716 PECOS PAC ID: 5092887273 Enrollment ID: I20080703000035 |
| Provider Name | Claire Marie Thorpe Klinsky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508121344 PECOS PAC ID: 1850538505 Enrollment ID: I20130516000509 |
| Provider Name | Justin Groennert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083230585 PECOS PAC ID: 4789008236 Enrollment ID: I20200716003901 |
| Mailing Address | Practice Location Address |
|---|---|
| Lebanon Optometric Center, Llc 201 W Saint Louis St, Lebanon, IL 62254-1515 Ph: (618) 537-6356 | Lebanon Optometric Center, Llc 201 W Saint Louis St, Lebanon, IL 62254-1515 Ph: (618) 537-6356 |
Justin Groennert, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 201 W Saint Louis St, Lebanon, IL 62254 Phone: 618-537-6356 | |
Dr. Claire M Klinsky, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 201 W Saint Louis St, Lebanon, IL 62254 Phone: 618-537-6356 Fax: 618-537-6358 | |
Robert Joseph Klinsky, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 103 N Pearl St, Lebanon, IL 62254 Phone: 618-537-6356 Fax: 618-537-6358 | |
Dr. Charissa Lee Thorpe, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 201 W Saint Louis St, Lebanon, IL 62254 Phone: 618-537-6356 Fax: 618-537-6358 |