Provider Demographics
NPI:1376818294
Name:VANGUARD MEDICAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:VANGUARD MEDICAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, CFO TPR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-2000
Mailing Address - Street 1:20 BURTON HILLS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6197
Mailing Address - Country:US
Mailing Address - Phone:615-665-6000
Mailing Address - Fax:615-665-6184
Practice Address - Street 1:1 ERIE CT
Practice Address - Street 2:SUITE 7010
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2566
Practice Address - Country:US
Practice Address - Phone:708-763-2225
Practice Address - Fax:708-763-2283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL7205Medicare PIN