Vital Link Physician Group Indiana

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VITAL LINK PHYSICIAN GROUP INDIANA

Practice address

2005 Hart St Ste 110
Dyer, IN 46311-1736

Phone

(212) 734-6621

NPI assigned

Nov 5, 2025

Organization subpart

No

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

Authorized official

Name

Matthew DubeNPI 1710125976

Title

Owner

Phone

(212) 734-6621

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Daniel Dube, M.D.

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1710125976

  IN, Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1558230672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 HART ST STE 110",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 HART ST STE 110",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111736",
            "telephone_number": "212-734-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL LINK PHYSICIAN GROUP INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-05",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "DUBE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-734-6621"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soniya Salil Vasanwala, DMD
• Jasmine Vayalil, DO
• Suganthi Vijayaraj, MD
• Arman Villanueva
• Maricor Villavicencio, PT
• VRM Enterprises Inc
• Mohammad Wadud
• Shauna Joy Walczak, PHARMD
• Rachael Beth Waldman, LCSW
• Ann M Waldron, APN

• Clinic/Center in Dyer, IN
• Providers in Dyer, IN by specialty
• Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.