WESTERN ILLINOIS MEDICAL GROUP, LLC
NPI 1205958741
Dermatology in Macomb, IL

NPI Status: Active since April 04, 2007

Contact Information

909 E GRANT ST
MACOMB, IL
ZIP 61455
Phone: (309) 837-7546
Fax: (312) 674-7546

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  • Organization
  • Dermatology
  • CLIA Number: 14D1012382
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 05-08-2027

About WESTERN ILLINOIS MEDICAL GROUP, LLC

This page provides the complete NPI Profile along with additional information for Western Illinois Medical Group, Llc, a provider established in Macomb, Illinois operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1205958741 assigned on April 2007. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Western Illinois Medical Group, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Xiaolu Li M.d. (Physician)

NPI
1205958741
Provider Name
WESTERN ILLINOIS MEDICAL GROUP, LLC
Entity Type
Organization
Location Address
909 E GRANT ST MACOMB, IL 61455
Location Phone
(309) 837-7546
Location Fax
(312) 674-7546
Mailing Address
909 E GRANT ST MACOMB, IL 61455
Mailing Phone
(309) 837-7546
Mailing Fax
(312) 674-7546
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-04-2007
Last Update Date
01-18-2023
Code Navigator

A dermatologist like Western Illinois Medical Group, Llc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

036099467 (IL)

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. XIAOLU LI M.D.

Authorized Official Title
PHYSICIAN
Authorized Official Phone
(309) 837-7546

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
039099467MEDICAID (05)IL 
05532018OTHER (01)ILBLUE CROSS BLUE SHEILD

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D1012382
Facility Type
Physician Office
Certificate Effective Date
May 09, 2025
Certificate Expiration Date
May 08, 2027
Laboratory Director
XIAOLU LI, M D
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Western Illinois Medical Group, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1205958741, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
0
Doubled → 0
Pos 4
5
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
5
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
7
Unchanged
Pos 9
4
Doubled → 8
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 8 → 16 → 7 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 0 + 5 + 1 + 8 + 5 + 1 + 6 + 7 + 8 + 24 = 69

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 69 is 70. The difference is the calculated check digit.

70 - 69 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1205958741.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dermatology
909 E GRANT ST
MACOMB, IL 61455
Family Medicine
909 E GRANT ST
MACOMB, IL 61455

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205958741, enumerated as an "organization" on April 04, 2007.

The provider is located at 909 E GRANT ST MACOMB, IL 61455 and the phone number is (309) 837-7546.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.