Organization
TARA N VAN DE WYNGAERDE OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA NICOLE VANDEWYNGAERDE O.D. (OWNER/OPTOMETRIST)
(815) 539-6291
Entity
Organization
Contact information
Practice address
700 14TH AVE, MENDOTA, IL 61342-1412
(815) 539-6291
(815) 539-3035
Mailing address
700 14TH AVE, MENDOTA, IL 61342-1412
(815) 539-6291
(815) 539-3035
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009989
IL
Other
Enumeration date
08/07/2007
Last updated
11/21/2025
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