Provider Demographics
NPI:1942215637
Name:WILEY, EVELYN R (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:R
Last Name:WILEY
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:2SOUTH020 TWIN OAKS DR.
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:630-668-8826
Mailing Address - Fax:630-665-9160
Practice Address - Street 1:2SOUTH020 TWIN OAKS DR.
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187
Practice Address - Country:US
Practice Address - Phone:630-665-9140
Practice Address - Fax:630-665-9160
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics