Individual
KIRUBEL ABEBE HERANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3311
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801
(217) 902-5292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01086235A
IN
207R00000X
Internal Medicine Physician
036.150405
IL
208M00000X
Hospitalist Physician
01086235A
IN
208M00000X
Hospitalist Physician
Primary
036.150405
IL
Other
Enumeration date
05/11/2017
Last updated
02/14/2022
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