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General NPI Number Information
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NPI Number | 1376527739
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Entity Type | Individual
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Provider Name | MEBEA AKLILU MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 901 W WELLINGTON AVE
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City | CHICAGO
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State | IL
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Zip | 60657-6708
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Country | US
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Telephone | 773-296-7248
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Fax |
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Provider Business Mailing Address
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Address Line | 701 LEE ST SUITE 300
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City | DES PLAINES
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State | IL
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Zip | 60016-4539
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Country | US
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Telephone | 847-390-5900
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Fax |
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 2004-00793
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 2004-00793
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 036-110116
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License Number State | IL
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