Provider Demographics
NPI:1598775728
Name:CHESTMED S.C.
Entity Type:Organization
Organization Name:CHESTMED S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YIPING
Authorized Official - Middle Name:
Authorized Official - Last Name:FU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-587-6112
Mailing Address - Street 1:901 S SOUTHMEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-4833
Mailing Address - Country:US
Mailing Address - Phone:847-587-6112
Mailing Address - Fax:847-587-6113
Practice Address - Street 1:100 S ATKINSON RD STE 201
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7821
Practice Address - Country:US
Practice Address - Phone:847-587-6112
Practice Address - Fax:847-587-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097168207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932467OtherBLUE CROSS/SHIELD
ILDD7448OtherRAIL ROAD MEDICARE
IL036097168Medicaid
IL036097168Medicaid