Provider Demographics
NPI:1467773986
Name:VERMYLEN, DAVID ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:VERMYLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 805
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-2402
Mailing Address - Country:US
Mailing Address - Phone:312-922-3815
Mailing Address - Fax:312-922-7449
Practice Address - Street 1:200 S MICHIGAN AVE
Practice Address - Street 2:SUITE 805
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-2402
Practice Address - Country:US
Practice Address - Phone:312-922-3815
Practice Address - Fax:312-922-7449
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036132542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine