Provider Demographics
NPI:1134100340
Name:KEMPERAS, THOMAS (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:KEMPERAS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-2990
Mailing Address - Country:US
Mailing Address - Phone:847-742-8742
Mailing Address - Fax:847-742-8765
Practice Address - Street 1:1287 W SPRING ST
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-2990
Practice Address - Country:US
Practice Address - Phone:847-742-8742
Practice Address - Fax:847-742-8765
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0046008537152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL114876OtherEYEMED VISION CARE
IL04532280OtherBLUECROSS BLUESHIELD PPO
IL364238781OtherVISION SERVICE PLAN
ILP01196983Medicare PIN
ILU35935Medicare UPIN