Provider Demographics
NPI:1255746525
Name:LECHER, KELLI M (OD)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:M
Last Name:LECHER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:
Other - Last Name:THEISEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1500 ASSOCIATES DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2201
Mailing Address - Country:US
Mailing Address - Phone:563-584-4415
Mailing Address - Fax:563-584-4256
Practice Address - Street 1:1500 ASSOCIATES DR
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2201
Practice Address - Country:US
Practice Address - Phone:563-584-4415
Practice Address - Fax:563-584-4256
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010775152W00000X
WI3536-35152W00000X
IA094173152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist