Provider Demographics
NPI:1821191594
Name:ZHANG, PING (NP)
Entity Type:Individual
Prefix:
First Name:PING
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19677
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9677
Mailing Address - Country:US
Mailing Address - Phone:217-545-8000
Mailing Address - Fax:217-788-5459
Practice Address - Street 1:315 W CARPENTER ST FL 1
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-4901
Practice Address - Country:US
Practice Address - Phone:217-545-8000
Practice Address - Fax:217-788-5459
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-007405363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid
DC0378816-00Medicaid
DC019976P54OtherMEDICARE (TRAILBLAZER) DC
IL$$$$$$$$$001Medicaid
IL$$$$$$$$$001Medicaid
IL522000009Medicare PIN
P87797Medicare UPIN