Provider Demographics
NPI:1982678207
Name:BERHE, TSEGHAI (MD)
Entity Type:Individual
Prefix:
First Name:TSEGHAI
Middle Name:
Last Name:BERHE
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 1:1555 BARRINGTON RD
Mailing Address - Street 2:SUITE 425, ROOM 5
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1019
Mailing Address - Country:US
Mailing Address - Phone:847-755-8695
Mailing Address - Fax:847-755-8694
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1019
Practice Address - Country:US
Practice Address - Phone:847-755-8695
Practice Address - Fax:847-755-8694
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2008-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL361139842080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036113984Medicaid
IL1982678207OtherNPI
ILK21517Medicare ID - Type Unspecified
ILK21516Medicare ID - Type Unspecified
IL036113984Medicaid