Organization
WILMA, LTD
Active
Other names
Pearle Vision Express
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER PAUL VIDULICH O.D. (OWNER/DOCTOR)
(773) 327-3000
Entity
Organization
Contact information
Practice address
904 W NORTH AVE, MELROSE PARK, IL 60160-1520
(708) 343-9009
(708) 343-9012
Mailing address
904 W NORTH AVE, MELROSE PARK, IL 60160-1520
(708) 343-9009
(708) 343-9012
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
060-005866
IL
332H00000X
Eyewear Supplier
060005866
IL
Other
Enumeration date
07/06/2006
Last updated
12/18/2008
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