Provider Demographics
NPI:1679734776
Name:LEMON & VO OD'S LTD.
Entity Type:Organization
Organization Name:LEMON & VO OD'S LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:LEMON
Authorized Official - Suffix:II
Authorized Official - Credentials:OD
Authorized Official - Phone:219-588-3349
Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-0045
Mailing Address - Country:US
Mailing Address - Phone:219-588-3349
Mailing Address - Fax:
Practice Address - Street 1:21430 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2215
Practice Address - Country:US
Practice Address - Phone:708-747-4198
Practice Address - Fax:708-747-6251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009316152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty