Individual
DR. BIFTU MEKONNEN MENGESHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 E SUPERIOR ST # 5-2177, CHICAGO, IL 60611-2914
(303) 819-3052
Mailing address
250 E SUPERIOR ST # 5-2177, CHICAGO, IL 60611-2914
(303) 819-3052
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
125059137
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125059137
IDPFR
IL
Enumeration date
06/21/2011
Last updated
06/21/2011
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