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General NPI Number Information
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NPI Number | 1275207045
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Entity Type | Individual
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Provider Name | GEMECHIS DIREBA MD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1400 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2334
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Country | US
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Telephone | 217-337-2000
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Fax | 217-337-3715
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Provider Business Mailing Address
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Address Line | 1400 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2334
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Country | US
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Telephone | 217-337-2000
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Fax | 217-337-3715
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036168269
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License Number State | IL
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