Basic Information
| Provider Information | |||||||||
| NPI: | 1215986377 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VILE | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 16335 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191140435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159697510 | ||||||||
| FaxNumber: | 2159697513 | ||||||||
| Practice Location | |||||||||
| Address1: | 8012 FRANKFORD AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191362616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156241758 | ||||||||
| FaxNumber: | 2156243153 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2006 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | OS006269L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RC0000X | OS006269L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 001412570004 | 05 | PA | MEDICAID | 0549116000 | 01 | PA | BLUE SHIELD | OTHER | 0549116000 | 01 | PA | KEYSTONE | OTHER | 24078 | 01 | PA | HEALTH PARTNERS | OTHER | 5618455 | 01 | PA | AETNA/USHC | OTHER | 712838 | 01 | PA | BLUE SHIELD | OTHER | 0549116000 | 01 | PA | BLUE SHIELD PC | OTHER | 0549116000 | 01 | PA | AMERI HEALTH | OTHER | 060052271 | 01 | PA | TRAVELERS MC | OTHER | 1028248 | 01 | PA | KEYSTONE MERCY | OTHER |