MEDICARE: DR. GERARD AYLWARD D.D.S. M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry		IL

General Provider Information

NPI Number	:	1255495081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERARD AYLWARD D.D.S. M.S.

Provider Business Mailing Address
First Line	:	7310 W NORTH AVE
Second Line	:	2A
City	:	ELMWOOD PARK
State	:	IL
Zip	:	60707-4252
Country	:	US
Telephone Number	:	708-456-5454
Fax Number	:	708-456-5497

Provider Business Practice Location Address
First Line	:	7310 W NORTH AVE
Second Line	:	2A
City	:	ELMWOOD PARK
State	:	IL
Zip	:	60707-4252
Country	:	US
Telephone Number	:	708-456-5454
Fax Number	:	708-456-5497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/08/2007

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