Kloke, Vivian M

Kloke, Vivian M is an sole proprietor health care provider with primary practice located at 735 Insight Ave , O Fallon IL 62269-2193. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kloke, Vivian M can be contacted via phone (618) 628-2903.

Contact Information

Primary practice address
735 Insight Ave O Fallon IL 62269-2193
Fax: (618) 628-2913
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046008375 Illinois

Profile Details

NPI number 1346358645
LBN Legal business name Kloke, Vivian M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 27th, 2006
Last updated Dec 12th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346358645 NPPES
Other 2202035 UNITED HEALTHCARE
Other 1801926340 UNITED HEALTHCARE
Other 259903 UNITED HEALTHCARE
Other 08206037 UNITED HEALTHCARE
MEDICAID 046008375 UNITED HEALTHCARE
Other 400662 UNITED HEALTHCARE

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