Doctor Name: | DR. ADDIS ALEMU ASFAW |
NPI Number: | 1043594914 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 125.058171 |
Business Practice Address: | 5454 Hohman Ave Hammond, IN - 463201931 |
Business Phone Number: | 8475055090 |
Business Fax Number: | |
Mailing Address: | 605 W Madison St, 2208 CHICAGO |
State: | IL |
Postal Code: | 606612410 |
Phone Number: | 8475055090 |
Fax Number: | |
NPI Enumeration Date: | 10/10/2011 |
NPI Last Update Date: | 07/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 125.058171 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |