# KIDANU BIRHANU MD SC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154548121
- **Authorized official:** KIDANU BIRHANU M.D (PHYSICIAN)
- **Authorized official phone:** (708) 229-1395

## Contact information

- **Practice address:** 5660 W 95TH ST, SUITE 3, OAK LAWN, IL 60453-2380
- **Practice address phone:** (708) 229-1395
- **Practice address fax:** (708) 857-4420
- **Mailing address:** 5660 W 95TH ST, SUITE 3, OAK LAWN, IL 60453-2380
- **Mailing address phone:** (708) 229-1395
- **Mailing address fax:** (708) 857-4420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036072060 | IL | Yes |

## Other

- **Enumeration date:** 04/19/2007
- **Last updated:** 06/24/2010