Provider Demographics
NPI:1720297203
Name:CASPER, DAVID J (OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:CASPER
Suffix:
Gender:M
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6551
Mailing Address - Country:US
Mailing Address - Phone:815-744-1400
Mailing Address - Fax:815-744-1177
Practice Address - Street 1:151 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6551
Practice Address - Country:US
Practice Address - Phone:815-744-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-007155152W00000X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X, 156F00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No156F00000XEye and Vision Services ProvidersTechnician/Technologist