David Vigder MD SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036094188 Issued in IL

Legal business name

DAVID VIGDER MD SC

Practice address

800 N Westmoreland Rd
Suite 206
Lake Forest, IL 60045-1673

Phone

(847) 615-2227

Fax

(847) 615-2228

NPI assigned

Jul 27, 2006

Last updated

Jul 10, 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 M Vidger, M.D.

Title

President

Phone

(847) 615-2227

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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 Vigder, MD

  • Internal Medicine Physician
  • Lake Forest, IL
  • NPI 1780773994
  Medicare reassignment NPD
• Carola Ann Tanna, M.D.

  • Internal Medicine Physician
  • Lexington, VA
  • NPI 1811005796
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1154345742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 206",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-615-2227",
            "fax_number": "847-615-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 206",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-615-2227",
            "fax_number": "847-615-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID VIGDER MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "VIDGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-615-2227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094188",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4922698",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deepak P Dalia, MD
• Daniel Joseph Dammrich, M.D.
• Jennifer Ann Daniels, MA
• Tricia Valters Danz, O.D.
• David E. Schmidt, D.D.S., P.C. (Lake Forest Smiles)
• Ann Bacon Davidsen, OTR/L
• Daniel Guillermo Davila, M.D.
• Benjamin Davis, M.D.
• Linda K. Davis, M ED
• Daniela Yvonne Dawson

• Internal Medicine Physician in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.