MEDICARE: DR. YEE-SHENG CHIU 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	207W00000X	Ophthalmology Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0326730001	OTHER	IL	DMERC
2	0002515001	OTHER	IL	BLUE CROSS BLUE SHIELD
3	133822	OTHER	IL	HEALTHLINK

General Provider Information

NPI Number	:	1083695407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YEE-SHENG CHIU M.D.

Provider Business Mailing Address
First Line	:	900 W TEMPLE AVE
Second Line	:	SUITE 104
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-2121
Country	:	US
Telephone Number	:	217-347-5525
Fax Number	:	217-342-6099

Provider Business Practice Location Address
First Line	:	900 W TEMPLE AVE
Second Line	:	SUITE 104
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-2121
Country	:	US
Telephone Number	:	217-347-5525
Fax Number	:	217-342-6099

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

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	01/22/2008

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