Elton Yichao Li, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036174328 Issued in IL

Practice address

102 N. Superior Avenue
Baraga, MI 49908

Phone

(906) 353-8700

NPI assigned

Jun 1, 2020

Last updated

Sep 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, CT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Michigan State University College of Human Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Belleville, IL, CCN 140185

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL, Single Specialty

  Medicare reassignment Care Compare group NPD
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1669445946

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Fairview Heights Medical Group SC

  dba BJC Medical Group of Illinois

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD
• Optimus Health Care Inc

  dba JP Morgan Chase Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1346516317
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1144844564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 902",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481670902",
            "telephone_number": "731-358-6654",
            "fax_number": "423-225-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N. SUPERIOR AVENUE",
            "city": "BARAGA",
            "state": "MI",
            "postal_code": "49908",
            "telephone_number": "906-353-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 N 7 Hills Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622694111",
            "country_code": "US",
            "telephone_number": "618-624-6181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16005 Pine Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481684818",
            "country_code": "US",
            "telephone_number": "731-358-6654",
            "fax_number": "423-225-8189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "ELTON",
        "middle_name": "YICHAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351046940",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301510061",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036174328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "310 N 7 Hills Rd Ste 220",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622694111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ann Marie Lanala
• John Matthew Lassila
• Matthew Stephen Lefevre
• Theresa Faye Massie
• Kathleen S Mayo, RN
• Northern Orthotics & Prosthetics
• Northern Sports and Family Chiropractic PLLC
• Kristine Nyquist, FNP

• Family Medicine Physician in Baraga, MI
• Providers in Baraga, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.