Birhanu, Kidanu

Birhanu, Kidanu is an individual health care provider with primary practice located at 24 Joliet St Ste 302, Dyer IN 46311-1705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Birhanu, Kidanu can be contacted via phone (219) 852-2518.

Contact Information

Primary practice address
24 Joliet St Ste 302 Dyer IN 46311-1705
Phone: (219) 852-2518
Fax: (219) 864-2156
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01066132 Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036072060 Illinois

Profile Details

NPI number 1710073952
LBN Legal business name Birhanu, Kidanu
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Mar 30th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710073952 NPPES
Illinois MEDICAID 036072060
Illinois Other 01633358
Illinois Other 110248456

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