MEDICARE: PAUL A VELD OD PLLC

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1477278000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL A VELD OD PLLC

Provider Business Mailing Address
First Line	:	1080 E EXCHANGE ST
Second Line	:
City	:	CRETE
State	:	IL
Zip	:	60417-3454
Country	:	US
Telephone Number	:	708-672-3937
Fax Number	:

Provider Business Practice Location Address
First Line	:	1080 E EXCHANGE ST
Second Line	:
City	:	CRETE
State	:	IL
Zip	:	60417-3454
Country	:	US
Telephone Number	:	708-672-3937
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. PAUL VELD
Credential	:	OD
Telephone Number	:	708-672-3937

Provider Enumeration Date	:	10/06/2022
Last Update Date	:	10/06/2022

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