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General NPI Number Information
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NPI Number | 1326095563
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Entity Type | Organization
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Legal Business Name | WILLIAM E. PAWLAK P C
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 2101 GATEWAY CENTER DR
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City | BELVIDERE
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State | IL
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Zip | 61008-9310
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Country | US
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Telephone | 815-547-5950
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Fax | 815-547-7057
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Provider Business Mailing Address
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Address Line | 2101 GATEWAY CENTER DR
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City | BELVIDERE
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State | IL
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Zip | 61008-9310
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Country | US
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Telephone | 815-547-5950
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Fax | 815-547-7057
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM PAWLAK
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Credential |
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Telephone | 847-650-3375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046009055
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License Number State | IL
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