NPIMap

Organization Active NPI

David a Vermylen MD SC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1760123236
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DAVID A VERMYLEN MD SC
Practice address
200 S Michigan Ave Ste 1400
Chicago, IL 60604-2426
Phone
(312) 922-3815
Fax
(312) 922-7449
NPI assigned
Apr 6, 2022
Last updated
Apr 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Authorized official

Name
Mr. Barbara Evans, CPC CPB
Title
Billing Manager
Phone
(630) 285-1530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

200 S Michigan Ave Ste 1400
Chicago, IL 60604-2426

Mailing address

200 S Michigan Ave Ste 1400
Chicago, IL 60604-2426
Phone (312) 922-3815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220809002244 IL Part B Supplier - Clinic/Group Practice 6507248457 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1760123236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MICHIGAN AVE STE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606042426",
            "telephone_number": "312-922-3815",
            "fax_number": "312-922-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MICHIGAN AVE STE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606042426",
            "telephone_number": "312-922-3815",
            "fax_number": "312-922-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A VERMYLEN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "630-285-1530",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPC CPB"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

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