Provider Demographics
NPI:1306869482
Name:CHAO, JULIE YIA PEI (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:YIA PEI
Last Name:CHAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YIA PEI
Other - Middle Name:
Other - Last Name:CHAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46581-0601
Mailing Address - Country:US
Mailing Address - Phone:260-969-1950
Mailing Address - Fax:260-918-2137
Practice Address - Street 1:600 EAST BLVD
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2483
Practice Address - Country:US
Practice Address - Phone:574-524-8130
Practice Address - Fax:574-524-8138
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041554A207L00000X
VA0101269752207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000091897OtherANTHEM BC/BS
IN050052674OtherRAILROAD MEDICARE
IN100376480Medicaid
INP00399829OtherRR MCARE
IN931510Medicare PIN
IN249110OMedicare PIN
INP00399829OtherRR MCARE
IN100376480Medicaid