| Western Illinois Medical Group, Llc | |
|
909 E Grant St Macomb IL 61455-3371 | |
| (309) 837-7546 | |
| (312) 674-7546 |
| Full Name | Western Illinois Medical Group, Llc |
|---|---|
| Speciality | Dermatology |
| Location | 909 E Grant St, Macomb, Illinois |
| Authorized Official Name and Position | Xiaolu Li (PHYSICIAN) |
| Authorized Official Contact | 3098377546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Illinois Medical Group, Llc 909 E Grant St Macomb IL 61455-3371 Ph: (309) 837-7546 | Western Illinois Medical Group, Llc 909 E Grant St Macomb IL 61455-3371 Ph: (309) 837-7546 |
| NPI Number | 1205958741 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 01/18/2023 |
| Medicare PECOS PAC ID | 1759337264 |
|---|---|
| Medicare Enrollment ID | O20050329000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205958741 | NPI | - | NPPES |
| 039099467 | Medicaid | IL | |
| 05532018 | Other | IL | BLUE CROSS BLUE SHEILD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036099467 (Illinois) | Secondary |
| 207N00000X | Dermatology | (* (Not Available)) | Primary |
| Provider Name | Zhong Ye |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1255406518 PECOS PAC ID: 8123091097 Enrollment ID: I20040818000606 |
Mcdonough County Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 E Grant St, Suite 202, Macomb, IL 61455 Phone: 309-833-4101 Fax: 309-836-1525 | |
Macomb Internal Medicine Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 E Grant St, Ste 111, Macomb, IL 61455 Phone: 309-837-9926 Fax: 309-833-1417 | |
Family Practice Associates Of Macomb Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 E Grant St, Suite 110 Family Practice Associates Of Macomb Ltd, Macomb, IL 61455 Phone: 309-833-1733 Fax: 309-836-2369 | |
Mcdonough County Hospital District Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 E Grant St Ste 213, Macomb, IL 61455 Phone: 309-837-6937 Fax: 309-837-1979 | |
Mcdonough County Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 E Jackson St, Macomb, IL 61455 Phone: 309-833-4101 | |
Graham Hospital Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1630 E Jackson St, Macomb, IL 61455 Phone: 309-647-5240 |