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CLARKSON EYECARE
NPI 1063606978
Optometrist in Breese, IL

Active since September 04, 2007CLIA 14D2094022 · Waiver
103 CLINTONIAN PLAZA, BREESE, IL 62230(636) 200-4393(618) 526-7455 Get Directions Write a Review

NPPES record last updated: June 21, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 21, 2019, Jun 4, 2019, Nov 8, 2017 (3 updates tracked since 2017).

About Clarkson Eyecare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARKSON EYECARE (NPI 1063606978) is a healthcare organization registered as an optometrist in Breese, Illinois and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through April 7, 2027 and lists James J Wachter, Cmo, as its authorized official.

NPPES Registry Identity

NPI1063606978
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameCLARKSON OPTOMETRY ILLINOIS PC
Location Address103 CLINTONIAN PLAZABreese, IL 62230
Mailing AddressPo Box 207163Dallas, TX 75320-7154 · (636) 200-4393 · Fax (636) 527-0766
Phone(636) 200-4393
Fax(618) 526-7455
Organization SubpartNo
Authorized OfficialJames J WachterCmo · (636) 200-4393
Enumeration DateSeptember 4, 2007
Last NPPES UpdateJune 21, 20193 updates tracked since enumeration
✔ NPI 1063606978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in IL · 036104178
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
103 CLINTONIAN PLAZA, Breese, IL 62230
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Other Names 1

Doing Business AsClarkson Eyecare

Other Identifiers 1

Medicaid036104178IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2094022

Clarkson Optometry Illinois, PC · Breese, IL
Active · expires Apr 7, 2027
CLIA Number14D2094022
Laboratory TypePhysician Office
Certificate Effective DateApril 8, 2025
Certificate Expiration DateApril 7, 2027
Laboratory DirectorJames Wachter Od
Laboratory Phone(618) 526-7447
Laboratory LocationClarkson Optometry Illinois, PC103 Clintonian Plaza, Breese, IL 62230
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clarkson Optometry Illinois PC's NPI number?

The NPI number for Clarkson Optometry Illinois PC is 1063606978. It was assigned to this organization in the NPPES registry on September 4, 2007. The provider is doing business as Clarkson Eyecare.

Where is Clarkson Optometry Illinois PC located?

Clarkson Optometry Illinois PC is located at 103 Clintonian Plaza, Breese, IL 62230. The listed phone number is (636) 200-4393.

What is Clarkson Optometry Illinois PC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Does Clarkson Optometry Illinois PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2094022) is associated with this NPI, valid through April 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clarkson Optometry Illinois PC was last updated on June 21, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.