NPIMap

Individual provider Active NPI

David Vigder, MD

  • Internal Medicine Physician
  • Lake Forest, IL
National Provider Identifier
1780773994
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036094188 Issued in IL
Practice address
800 N Westmoreland Rd
Suite 206
Lake Forest, IL 60045-1673
Phone
(847) 615-2227
Fax
(847) 615-2228
NPI assigned
Oct 12, 2006
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036094188 IL Primary

Addresses

Primary practice location

800 N Westmoreland Rd
Suite 206
Lake Forest, IL 60045-1673

Mailing address

800 N Westmoreland Rd
Suite 206
Lake Forest, IL 60045-1673
Phone (847) 615-2227

Other identifiers 1

IdentifierTypeStateIssuer
4922698OtherILBLUE SHIELD BLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dvigder15711@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000823 IL Practitioner - Internal Medicine 9638161540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2501 Compass Rd
Suite 100
Glenview, IL 60026-8000
Phone (847) 650-1281

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036094188ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David Vigder MD SC Internal Medicine CurrentSince Jun 20, 2023 Accepting new patients
Richard J Siebert, M.D.,S,C. Internal Medicine Past Accepting new patients
Northwestern Memorial Physicians Group Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 306
Bannockburn, IL 60015
Phone (847) 650-1281

6319 Paysphere Cir
Chicago, IL 60674

2501 Compass Rd
Ste 100
Glenview, IL 60026
Phone (847) 869-1499

800 N Westmoreland Rd
Ste 100C
Lake Forest, IL 60045
Phone (847) 615-2227

800 N Westmoreland Rd
Ste 206
Lake Forest, IL 60045
Phone (847) 295-2445

Interoperability endpoints

  • Direct secure messaging: dvigder15711@direct.northshore.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1780773994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 206",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-615-2227",
            "fax_number": "847-615-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 206",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-615-2227",
            "fax_number": "847-615-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGDER",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD BLUE CROSS",
            "identifier": "4922698",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvigder15711@direct.northshore.org",
            "affiliation": "N",
            "address_1": "800 N Westmoreland Rd",
            "address_2": "SUITE 206",
            "city": "Lake Forest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600451673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.