Healthcare Provider Details
I. General information
NPI: 1861357279
Provider Name (Legal Business Name): TEMESGEN YOHANNES ADINO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 WILMOT RD # 2002
DEERFIELD IL
60015-5145
US
IV. Provider business mailing address
4040 N CICERO AVE
CHICAGO IL
60641-1807
US
V. Phone/Fax
- Phone: 847-315-2500
- Fax:
- Phone: 773-283-5321
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 051307765 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: