Li, Fang

Li, Fang is an individual health care provider with primary practice located at 2204 Eastland Dr , Bloomington IL 61704-3566. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Li, Fang can be contacted via phone (309) 662-9461.

Contact Information

Primary practice address
2204 Eastland Dr Bloomington IL 61704-3566
Phone: (309) 662-9461
Fax: (309) 663-0222
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036095578 Illinois
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036095578 Illinois

Profile Details

NPI number 1356447841
LBN Legal business name Li, Fang
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Apr 1st, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356447841 NPPES
Illinois Other 5715381 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036095578 BLUE CROSS BLUE SHIELD
Illinois Other 130016944 BLUE CROSS BLUE SHIELD

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