Polly Marie Vaughn

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180009894 Issued in IL

Practice address

206 Chesterfield CT
Bourbonnais, IL 60914-9652

Phone

(815) 603-2425

NPI assigned

Nov 9, 2015

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

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

Enrolled in DE, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1750754008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2199",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609011199",
            "telephone_number": "815-603-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CHESTERFIELD CT",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609149652",
            "telephone_number": "815-603-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "POLLY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W Van Dehey, DC
• Vandehey Chiropractic Health Center
• Lisa Vander Veer, PSYD
• Salil R Vasanwala, M.D.
• Brian David Vaughn
• Victor Manuel Vazquez Cervantes, PHARMD
• Rebecca Ellen Veasey, PA-C
• Cole Jonathan Verbrugge, DC
• Mark Vidas, O.D.
• Edwin Viglia III, LPC

• Professional Counselor in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.