Healthcare Provider Details

I. General information

NPI: 1306413976
Provider Name (Legal Business Name): DAVID J.CASPER,OD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 SPRINGFIELD AVE STE 5
JOLIET IL
60435-6551
US

IV. Provider business mailing address

151 SPRINGFIELD AVE
JOLIET IL
60435-6551
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-1400
  • Fax: 815-744-1177
Mailing address:
  • Phone: 815-744-1400
  • Fax: 815-744-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID J CASPER
Title or Position: OWNER
Credential: OD
Phone: 815-744-1400