Provider Demographics
NPI:1225093883
Name:VELD, PAUL A (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:VELD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 E EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-3454
Mailing Address - Country:US
Mailing Address - Phone:708-672-3937
Mailing Address - Fax:708-672-3940
Practice Address - Street 1:1080 E EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-3454
Practice Address - Country:US
Practice Address - Phone:708-672-3937
Practice Address - Fax:708-672-3940
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008221152W00000X
IN18002500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist