MEDICARE: YANBING LI 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	207Q00000X	Family Medicine Physician	036-111693	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1619414	OTHER	IL	BCBS GROUP #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104843739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANBING LI M.D.

Provider Business Mailing Address
First Line	:	13707 W JACKSON ST
Second Line	:
City	:	WOODSTOCK
State	:	IL
Zip	:	60098-3188
Country	:	US
Telephone Number	:	815-337-1871
Fax Number	:	815-338-6297

Provider Business Practice Location Address
First Line	:	360 STATION DR
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-7978
Country	:	US
Telephone Number	:	815-338-6600
Fax Number	:	815-477-9826

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	04/09/2024

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