Provider Demographics
NPI:1639159379
Name:CHOW, KEE YOUNG (MD)
Entity Type:Individual
Prefix:
First Name:KEE
Middle Name:YOUNG
Last Name:CHOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:K
Other - Last Name:CHOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:49 COUNTRY CLUB PL
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3450
Mailing Address - Country:US
Mailing Address - Phone:309-662-4770
Mailing Address - Fax:
Practice Address - Street 1:2304 STERN DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4487
Practice Address - Country:US
Practice Address - Phone:309-663-0411
Practice Address - Fax:309-662-2018
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5700239OtherBC/BS GROUP NUMBER
L98947OtherPIN
IL205915Medicare ID - Type UnspecifiedGROUP NUMBER
D84382Medicare UPIN