Active NPI
Daniel Robert Wyma, MD
- Psychiatry Physician
- Wheaton, IL
National Provider Identifier
1336212299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036063557
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036063557 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036063557 | IL | MD | Psychiatry Physician |
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": "1336212299",
"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": "WYMA",
"first_name": "DANIEL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2011-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036063557",
"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.