Organization
ILYAS OPTICAL INC.
Active
Other names
New Wilson Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID D DEWAARD O.D. (OWNER)
(708) 345-4040
Entity
Organization
Contact information
Practice address
217 S 5TH AVE # B, MAYWOOD, IL 60153-1647
(708) 345-4040
(708) 345-5534
Mailing address
217 S 5TH AVE # B, MAYWOOD, IL 60153-1647
(708) 345-4040
(708) 345-5534
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007174
IL
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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