Individual provider Active NPI

Daphne L Vander Roest, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1932513934
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
336.103699 Issued in IL
Practice address
1801 W Taylor St Ste 2E
Chicago, IL 60612
Phone
(312) 996-7416
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125-065354 IL
Pediatrics Physician 208000000X 336.103699 IL Primary
Pediatrics Physician 208000000X 036.142322 IL

Addresses

Primary practice location

1801 W Taylor St Ste 2E
Chicago, IL 60612

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686

Other practice location 1

800 E 55th St
Chicago, IL 60615-4906
Phone (773) 702-0660

Other practice location 2

5841 S Maryland Ave # 8016K155
Chicago, IL 60637-1447
Phone (773) 702-7553

Other names 1

  • Daphne Polymnia Lambropoulos Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031001660 IL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8224332994 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142322ILMDPediatrics Physician
125-065354ILMDPediatrics Physician
336.103699ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Pediatrics Current Accepting new patients
Friend Family Health Center Inc CurrentSince Sep 10, 2017 Accepting new patients
Friend Family Health Center Inc CurrentSince Sep 10, 2017 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 14, 2018 Accepting new patients
Friend Family Health Center Inc Current Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 19, 2017 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Aug 14, 2018 Accepting new patients

Locations

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

9532 Eagle Way
Chicago, IL 60678

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

7732 Solution Ctr
Dept 3445 PEDS
Chicago, IL 60677

1801 W Taylor St
Ste 2E
Chicago, IL 60612
Phone (312) 996-7416

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1932513934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST STE 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-7416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E 55th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606154906",
            "country_code": "US",
            "telephone_number": "773-702-0660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5841 S Maryland Ave # 8016K155",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-702-7553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDER ROEST",
        "first_name": "DAPHNE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125-065354",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "336.103699",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.142322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAPHNE",
            "last_name": "LAMBROPOULOS",
            "middle_name": "POLYMNIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.