Healthcare Provider Details

I. General information

NPI: 1619610540
Provider Name (Legal Business Name): DAVID VAN ARSDELL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23W620 HEMLOCK LN
NAPERVILLE IL
60540-9510
US

IV. Provider business mailing address

23W620 HEMLOCK LN
NAPERVILLE IL
60540-9510
US

V. Phone/Fax

Practice location:
  • Phone: 630-986-7245
  • Fax:
Mailing address:
  • Phone: 630-986-7245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number060199247
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA12779400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number82439
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number82045
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: