Provider Demographics
NPI:1043399850
Name:KRAEMER & VOGEL OD LTD
Entity Type:Organization
Organization Name:KRAEMER & VOGEL OD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ERROL
Authorized Official - Last Name:KRAEMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:618-235-4433
Mailing Address - Street 1:3540 N BELT W
Mailing Address - Street 2:SUITE C
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5975
Mailing Address - Country:US
Mailing Address - Phone:618-235-4433
Mailing Address - Fax:618-235-7483
Practice Address - Street 1:3540 N BELT W
Practice Address - Street 2:SUITE C
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5975
Practice Address - Country:US
Practice Address - Phone:618-235-4433
Practice Address - Fax:618-235-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL466468332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL643550Medicare ID - Type Unspecified
IL643560Medicare ID - Type Unspecified
IL0424340001Medicare NSC