| Endale T Mekonen Md Pc | |
|
4425 Madison St Skokie IL 60076-2627 | |
| (708) 479-6522 | |
| (708) 479-6597 |
| Full Name | Endale T Mekonen Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4425 Madison St, Skokie, Illinois |
| Authorized Official Name and Position | Endale T Mekonen (PRESIDENT) |
| Authorized Official Contact | 7084796522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endale T Mekonen Md Pc 4425 Madison St Skokie IL 60076-2627 Ph: (708) 479-6522 | Endale T Mekonen Md Pc 4425 Madison St Skokie IL 60076-2627 Ph: (708) 479-6522 |
| NPI Number | 1790822906 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 06/14/2011 |
| Medicare PECOS PAC ID | 6608957725 |
|---|---|
| Medicare Enrollment ID | O20080115000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790822906 | NPI | - | NPPES |
| 036085841 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 036085841 (Illinois) | Primary |
| Provider Name | Endale T Mekonen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1790701472 PECOS PAC ID: 2264513381 Enrollment ID: I20080115000528 |
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