Active NPI
David James Vandyke, PHD
- Marriage & Family Therapist
- Wheaton, IL
National Provider Identifier
1164595120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166000545
- Practice address
- 1761 S Naperville Rd
Ste 200
Wheaton, IL 60189-5846 - Phone
- (630) 260-0606
- Fax
- (630) 260-1049
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166000545 | IL | Primary |
Addresses
Primary practice location
1761 S Naperville Rd
Ste 200
Wheaton, IL 60189-5846
Mailing address
1761 S Naperville Rd
Ste 200
Wheaton, IL 60189-5846
Phone (630) 260-0606
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166000545 | IL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Clinical Services PC | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319587200000",
"number": "1164595120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1761 S NAPERVILLE RD",
"address_2": "STE 200",
"city": "WHEATON",
"state": "IL",
"postal_code": "601895846",
"telephone_number": "630-260-0606",
"fax_number": "630-260-1049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1761 S NAPERVILLE RD",
"address_2": "STE 200",
"city": "WHEATON",
"state": "IL",
"postal_code": "601895846",
"telephone_number": "630-260-0606",
"fax_number": "630-260-1049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDYKE",
"first_name": "DAVID",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2011-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166000545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.