Individual
DR. D DAVID PESAVENTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
963 129TH INFANTRY DR, SUITE 110, JOLIET, IL 60435
(815) 725-8425
(815) 725-2607
Mailing address
963 N 129TH INFANTRY DR, SUITE110, JOLIET, IL 60435-3104
(815) 725-8425
(815) 725-2607
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007408
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MP1396387
PEA
—
Enumeration date
05/12/2006
Last updated
01/16/2014
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