Tesfamariam Kefle, LCSW | |
1609 Sherman Ave, Evanston, IL 60201-3753 | |
(773) 577-6178 | |
(847) 390-8214 |
Full Name | Tesfamariam Kefle |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1609 Sherman Ave, Evanston, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225403652 | NPI | - | NPPES |
149.009875 | Other | IL | LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.009875 (Illinois) | Primary |
Entity Name | Vitae Health Of Illinois Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174013452 PECOS PAC ID: 2365798410 Enrollment ID: O20180703002838 |
Mailing Address | Practice Location Address |
---|---|
Tesfamariam Kefle, LCSW 6240 N Drake Ave, Chicago, IL 60659-2204 Ph: (773) 577-6178 | Tesfamariam Kefle, LCSW 1609 Sherman Ave, Evanston, IL 60201-3753 Ph: (773) 577-6178 |
Tabitha Ledbetter, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 355 Ridge Ave Fl 2, Evanston, IL 60202 Phone: 847-316-6262 Fax: 847-316-2214 | |
Kathleen Ann Valadez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 355 Ridge Ave Fl 2, Evanston, IL 60202 Phone: 847-316-3703 | |
Kathleen A. Bogie, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2143 Lincolnwood Dr, Evanston, IL 60201 Phone: 224-392-5467 | |
Gabrielle Celia Stern, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2530 Crawford Ave Ste 207, Evanston, IL 60201 Phone: 847-732-5305 | |
Susan Burkhardt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1005 Mulford St, Evanston, IL 60202 Phone: 847-328-8207 | |
Ellen Kenemore, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 708 Church St, Suite 227, Evanston, IL 60201 Phone: 847-491-0080 Fax: 847-251-1266 | |
Nora Josephine Walsh, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 636 Church St Ste 507, Evanston, IL 60201 Phone: 847-409-6288 |