Provider Demographics
NPI:1336766377
Name:KANE, ALEXANDER REMINGTON (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:REMINGTON
Last Name:KANE
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 1:2809 MANSION RD
Mailing Address - Street 2:STE A
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-6811
Mailing Address - Country:US
Mailing Address - Phone:217-899-7997
Mailing Address - Fax:
Practice Address - Street 1:2809 MANSION RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-6811
Practice Address - Country:US
Practice Address - Phone:217-899-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist