Provider Demographics
NPI:1922587591
Name:WARD, ASHLYN (OD)
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ASHLYN
Other - Middle Name:
Other - Last Name:DEHOOGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2762
Mailing Address - Country:US
Mailing Address - Phone:630-232-7800
Mailing Address - Fax:
Practice Address - Street 1:500 S 3RD ST STE 105
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2763
Practice Address - Country:US
Practice Address - Phone:630-232-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011231152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist