Individual
ABEBE FISSEHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3849 NORTHRIDGE DR, ROCKFORD, IL 61114-4773
(815) 636-0333
(815) 636-0149
Mailing address
3849 NORTHRIDGE DR, ROCKFORD, IL 61114-4773
(815) 505-2943
(815) 636-0149
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051292525
IL
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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