Healthcare Provider Details

I. General information

NPI: 1164671921
Provider Name (Legal Business Name): PAUL A VELD OD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14785 W 101ST AVE STE 104
DYER IN
46311-3371
US

IV. Provider business mailing address

14785 W 101ST AVE STE 104
DYER IN
46311-3371
US

V. Phone/Fax

Practice location:
  • Phone: 708-672-3937
  • Fax: 708-672-3940
Mailing address:
  • Phone: 708-672-3937
  • Fax: 708-672-3940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18002500
License Number StateIN

VIII. Authorized Official

Name: PAUL A VELD
Title or Position: OWNER
Credential: OD
Phone: 708-672-3937