Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tara N Van De Wyngaerde OD PC

Organization Optometrist · NPI 1215128806

Tara N Van De Wyngaerde OD PC is an Optometrist in Mendota, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

700 14th Ave
Mendota, IL 61342-1412
Phone: (815) 539-6291
Fax: (815) 539-3035
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 046009989 (IL)

Record details

NPI number1215128806
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tara Vandewyngaerde — Owner/Optometrist · (815) 539-6291
NPI enumeratedAugust 7, 2007
Last updated in NPPESNovember 21, 2025
Certification dateNovember 21, 2025
Mailing address700 14th Ave, Mendota, IL 61342-1412

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