Yiran Gong, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036171093 Issued in IL

Practice address

2160 S 1St Ave RM 7609
Maywood, IL 60153

Phone

(708) 216-8757

Fax

(708) 216-1259

NPI assigned

Mar 30, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Pulmonary DiseaseAlso: Internal Medicine

Education

Tufts University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093
• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Osf Heart of Mary Medical Center Hospital, Urbana, IL, CCN 140113

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 and National Provider Directory roles.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• Osf Healthcare System

  • Land Ambulance
  • Urbana, IL
  • NPI 1093228835

  Hospital

  Care Compare affiliation
• Osf Healthcare System

  • Psychiatric Hospital Unit
  • Urbana, IL
  • NPI 1649783473
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1659884476
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Danville, IL
  • NPI 1699288449
  Care Compare affiliation
• St Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation
• The Carle Foundation Hospital

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1013071653
  Care Compare affiliation

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1942705967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 JACKSON BLVD APT F1",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601303226",
            "telephone_number": "918-549-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE RM 7609",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-8757",
            "fax_number": "708-216-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "YIRAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-30",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.073117",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036171093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Goldsher, MD
• Lucy Elaine Gomez Timana, MD
• Angela Teresa Gomez-Lam, M.D.
• Angelica Elizabeth Gomez, PTA
• Michael S Gong, MD
• Ilana Gonik, PHD
• Gustavo Adolfo Gonzalez Garcia, M.D.
• Tania Cristina Gonzalez-Rivera, MD, MPH
• Ana P Gonzalez, MD
• Christopher Gonzalez, MD

• Pulmonary Disease Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.