Provider Demographics
NPI:1285727214
Name:LAWRENCE KESSLER AND ASSOC.,LTD.
Entity type:Organization
Organization Name:LAWRENCE KESSLER AND ASSOC.,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-377-2360
Mailing Address - Street 1:1514 W CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-4427
Mailing Address - Country:US
Mailing Address - Phone:217-377-2360
Mailing Address - Fax:217-398-2801
Practice Address - Street 1:44 E. MAIN STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3636
Practice Address - Country:US
Practice Address - Phone:217-356-5377
Practice Address - Fax:217-356-5379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-6931152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1626Medicare PIN