Provider Demographics
NPI:1013923929
Name:LI, YIBING (MD)
Entity Type:Individual
Prefix:
First Name:YIBING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5401 N KNOXVILLE AVE
Mailing Address - Street 2:STE 117
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-5098
Mailing Address - Country:US
Mailing Address - Phone:309-689-8888
Mailing Address - Fax:309-689-8410
Practice Address - Street 1:5401 N KNOXVILLE AVE
Practice Address - Street 2:STE 117
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-5098
Practice Address - Country:US
Practice Address - Phone:309-689-8888
Practice Address - Fax:309-689-8410
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036113585208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL080182079OtherRAILROAD MEDICARE
IL106905OtherHEALTH ALLIANCE
IL563097OtherHEALTHLINK
ILIL01L9OtherJOHN DEERE
IL0361135851Medicaid
IL7215059OtherBCBS PPO
ILI30842Medicare UPIN
ILIL01L9OtherJOHN DEERE