MEDICARE: DR. QING LI PH.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	170100000X	Ph.D. Medical Genetics	DI55025	FL

General Provider Information

NPI Number	:	1811850456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QING LI PH.D.

Provider Business Mailing Address
First Line	:	51246 LEEWARD PT
Second Line	:
City	:	GRANGER
State	:	IN
Zip	:	46530-4825
Country	:	US
Telephone Number	:	425-830-2637
Fax Number	:	847-807-4403

Provider Business Practice Location Address
First Line	:	9213 PARKLANE AVE
Second Line	:
City	:	FRANKLIN PARK
State	:	IL
Zip	:	60131-2837
Country	:	US
Telephone Number	:	847-329-7500
Fax Number	:	847-807-4403

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ DR. QING LI PH.D.” Practice Location

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