MEDICARE: DR. YIPING FU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	036097168	IL
2	207R00000X	Internal Medicine Physician	036097168	IL
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036097168	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043205107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YIPING FU M.D.

Provider Business Mailing Address
First Line	:	2520 ELISHA AVE
Second Line	:
City	:	ZION
State	:	IL
Zip	:	60099
Country	:	US
Telephone Number	:	847-872-4561
Fax Number	:	847-548-9216

Provider Business Practice Location Address
First Line	:	2361 PAYSPHERE CIR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674
Country	:	US
Telephone Number	:	847-746-4358
Fax Number	:	847-548-9216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	03/22/2021

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