Provider Demographics
NPI:1225346885
Name:GEBEYEHU, KINFE (MD)
Entity Type:Individual
Prefix:
First Name:KINFE
Middle Name:
Last Name:GEBEYEHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1825
Mailing Address - Country:US
Mailing Address - Phone:708-383-8141
Mailing Address - Fax:708-383-9140
Practice Address - Street 1:1125 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1825
Practice Address - Country:US
Practice Address - Phone:708-383-8141
Practice Address - Fax:708-383-9140
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care