Provider Demographics
NPI:1144241035
Name:JAMES F. KRENZ, O.D. P.C.
Entity Type:Organization
Organization Name:JAMES F. KRENZ, O.D. P.C.
Other - Org Name:ROCK FALLS VISION SOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:KRENZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:815-626-7700
Mailing Address - Street 1:PO BOX 874
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-0874
Mailing Address - Country:US
Mailing Address - Phone:815-626-7700
Mailing Address - Fax:815-626-0268
Practice Address - Street 1:102 W ROCK FALLS RD
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-0874
Practice Address - Country:US
Practice Address - Phone:815-626-7700
Practice Address - Fax:815-626-0268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9815400OtherBLUECROSS BLUESHIELD
IL0416030001Medicare NSC
IL9815400OtherBLUECROSS BLUESHIELD