Organization
ENDALE MEKONEN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENDALE MEKONEN MD (PRESIDENT)
(708) 479-6522
Entity
Organization
Contact information
Practice address
4425 MADISON ST, SKOKIE, IL 60076-2627
(708) 479-6522
(708) 479-6597
Mailing address
4425 MADISON ST, SKOKIE, IL 60076-2627
(708) 479-6522
(708) 479-6597
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036085841
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085841
—
IL
Enumeration date
03/05/2007
Last updated
07/11/2008
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