Search › Illinois › 152W00000X
Tara Vandewyngaerde, O.D
NPI 1528264603 · on the registry since 2007 · sole proprietor
Practice
- Address
- 700 14th Ave
Mendota, IL 61342 - Phone
- (815) 539-6291
- Fax
- (815) 539-3035
- Organisation at this address
- Tara N Van De Wyngaerde Od Pc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-01-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois