NPI 1104156009

Wow Vision PC

Organisation Optometrist Woodridge, IL

Practice location

Address: 7451 Woodward Ave Suite 101, Woodridge, IL 60517-2665
Phone: (630) 663-9112
Fax: (630) 663-9228

Authorised official

Name: Mark D Wilmoth
Title: President and Ceo
Phone: (630) 663-9112

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 046009127 (IL)

Other Optometrist providers in Illinois →

Registry record

NPI: 1104156009
Entity type: Organization
NPI issued: 28 Dec 2009
Record last updated: 2 Jan 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.