Individual
AMEHA AMENE HAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 E 51ST ST, CHICAGO, IL 60615-2400
(312) 572-2643
Mailing address
500 E 51ST ST, CHICAGO, IL 60615-2400
(312) 572-2643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125051290
IL
Other
Enumeration date
09/27/2008
Last updated
09/27/2008
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