Individual
DR. YOHANNES GHIDEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6000 BOND AVE, EAST SAINT LOUIS, IL 62207-2328
(618) 332-2740
(618) 332-8755
Mailing address
6000 BOND AVE, EAST SAINT LOUIS, IL 62207-2328
(618) 332-2740
(618) 332-8755
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036081694
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296885682
—
IL
Enumeration date
07/30/2006
Last updated
11/18/2011
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