Ilyas Optical Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ILYAS OPTICAL INC

Doing business as

Wilson Optical

Practice address

1217 W Wilson Ave
Chicago, IL 60640-5516

Phone

(773) 271-5774

Fax

(773) 271-0741

NPI assigned

May 14, 2008

Last updated

Mar 29, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David D Dewaard, O. D.NPI 1013086990

Title

Owner/President

Phone

(773) 271-5774

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WILSON OPTICAL Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Ilyas Optical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ilyas Optical Inc.

  dba New Wilson Optical

  • Optometrist
  • Maywood, IL
  • NPI 1124339387
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David D Dewaard, O.D.

  • Corneal and Contact Management Optometrist
  • Chicago, IL
  • NPI 1013086990
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1437326808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 W WILSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405516",
            "telephone_number": "773-271-5774",
            "fax_number": "773-271-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 W WILSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405516",
            "telephone_number": "773-271-5774",
            "fax_number": "773-271-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILYAS OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "DEWAARD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "773-271-5774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O. D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "046007174",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007174",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILSON OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Illumination Counseling LTD.
• Ilmfc LLC
• Eucharia N Iloegbunam
• Susanna Ilori, RN
• Courtney Ilundain, APN
• Faraz Ilyas
• Irfana Ilyas, DMD
• Christina Chae Hyun Im, DMD
• Helen Im, BCBA
• Hyeyon Im, PT, DPT, OCS

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.