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General NPI Number Information
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NPI Number | 1891927778
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Entity Type | Organization
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Legal Business Name | DR GERARD AYLWARD ORTHODONTICS, PC
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 222 PLUM GROVE ROAD STE 2
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City | PALATINE
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State | IL
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Zip | 60067
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Country | US
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Telephone | 847-721-5061
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Fax | 847-359-3012
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Provider Business Mailing Address
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Address Line | 710 BRAEBURN RD
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City | INVERNESS
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State | IL
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Zip | 60067-4224
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Country | US
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Telephone | 847-358-9000
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Fax | 847-359-3012
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. GERARD AYLWARD
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Credential | BDS, MS
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Telephone | 708-456-5454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 021001218
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License Number State | IL
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