Provider Demographics
NPI:1710058946
Name:KATCHER, JOEL B (OD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:B
Last Name:KATCHER
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 1:2309 W SCHAUMBURG RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3893
Mailing Address - Country:US
Mailing Address - Phone:847-352-5556
Mailing Address - Fax:847-352-5638
Practice Address - Street 1:2309 W SCHAUMBURG RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3893
Practice Address - Country:US
Practice Address - Phone:847-352-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0626510001Medicare NSC
IL36739Medicare UPIN
IL511030Medicare ID - Type Unspecified