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Contact Information

DENNIS R VAUGHN, DPM
1640 NORTH STATE HIGHWAY 121
MOUNT ZION, IL62549
 Phone: 217-864-1922
 Fax: 217-864-1953
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for DENNIS R VAUGHN · (Male)

NPI # 1497789572
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/11/2006
Last updated 11/09/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 016005005
  • IL Medicaid 016005005
Hospital affiliation(s)
  • DECATUR MEMORIAL HOSPITAL - (Acute Care)
    2300 NORTH EDWARD STREET
    DECATUR, IL 62526
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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