Provider Demographics
NPI:1982680237
Name:KLUVER, CHAD R (OD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:R
Last Name:KLUVER
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 1:777 TANGLEFOOT LN
Mailing Address - Street 2:EYE SURGEONS ASSOCIATES PC
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1650
Mailing Address - Country:US
Mailing Address - Phone:563-323-2020
Mailing Address - Fax:563-328-5694
Practice Address - Street 1:777 TANGLEFOOT LN
Practice Address - Street 2:EYE SURGEONS ASSOCIATES PC
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1650
Practice Address - Country:US
Practice Address - Phone:563-323-2020
Practice Address - Fax:563-328-5694
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02304152W00000X
IL046009707152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0443077Medicaid
IA0740183OtherIA GROUP MEDICAID
IL977130OtherIL GROUP MEDICARE
V01498Medicare UPIN
IA0740183OtherIA GROUP MEDICAID
IA0443077Medicaid