Individual provider Active NPI

Mary Yee Chow, M.D.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Bloomington, IL
National Provider Identifier
1609896380
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
036107551 Issued in IL
Practice address
1505 Eastland Dr
Suite1000
Bloomington, IL 61701-3534
Phone
(309) 661-6270
Fax
(309) 862-4823
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 036107551 IL Primary

Addresses

Primary practice location

1505 Eastland Dr
Suite1000
Bloomington, IL 61701-3534

Mailing address

1505 Eastland Dr
Suite1000
Bloomington, IL 61701-3534
Phone (309) 661-6270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000819 IL Practitioner - Preventive MedicinePractitioner - Internal Medicine 9739257262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036107551ILMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1505 Eastland Dr
Ste 110
Bloomington, IL 61701
Phone (309) 662-8231

1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100

1505 Eastland Dr
Ste 1000
Bloomington, IL 61701
Phone (309) 661-6270

1701 E College Ave
Bloomington, IL 61704
Phone (309) 664-3000

1505 Eastland Dr
Ste 1100
Bloomington, IL 61701
Phone (309) 663-2100

801 Fox Run
Heyworth, IL 61745
Phone (309) 473-2069

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1609896380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "address_2": "SUITE1000",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-661-6270",
            "fax_number": "309-862-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "address_2": "SUITE1000",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-661-6270",
            "fax_number": "309-862-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEE CHOW",
        "first_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "IL",
            "license": "036107551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.