Individual provider Active NPI

David Aaron Galvan, IDC

  • Independent Duty Corpsman
  • Great Lakes, IL
National Provider Identifier
1033319827
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
3001 6TH St Ste a
Great Lakes, IL 60088-2833
Phone
(847) 688-7005
NPI assigned
Jul 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

3001 6TH St Ste a
Great Lakes, IL 60088-2833

Mailing address

2205 Matthew PL
Zion, IL 60099-2011
Phone (847) 246-3247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1033319827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 MATTHEW PL",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992011",
            "telephone_number": "847-246-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 6TH ST STE A",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVAN",
        "first_name": "DAVID",
        "middle_name": "AARON",
        "name_prefix": "Prof.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.