Brian David Vaughn

Primary specialty

DriverTaxonomy code 172A00000X

License

CK72961 Issued in IL

Practice address

1671 Greenbriar Dr
Bourbonnais, IL 60914-5093

Phone

(815) 216-1599

NPI assigned

Dec 6, 2022

Last updated

Dec 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1750092276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 GREENBRIAR DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145093",
            "telephone_number": "815-216-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 GREENBRIAR DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145093",
            "telephone_number": "815-216-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "IL",
            "license": "CK72961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John A Vallone, D.D.S.
• David W Van Dehey, DC
• Vandehey Chiropractic Health Center
• Lisa Vander Veer, PSYD
• Salil R Vasanwala, M.D.
• Polly Marie Vaughn
• Victor Manuel Vazquez Cervantes, PHARMD
• Rebecca Ellen Veasey, PA-C
• Cole Jonathan Verbrugge, DC
• Mark Vidas, O.D.

• Driver in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Driver in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.