Provider Demographics
NPI:1194827642
Name:KESSLER, LAWRENCE HOWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:HOWARD
Last Name:KESSLER
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 1:1514 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:217-377-2801
Mailing Address - Fax:
Practice Address - Street 1:44 E. MAIN STREET
Practice Address - Street 2:SUIT 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
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-006931152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist