MEDICARE: DR. ALEMAYEHU BEKELE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0032600300	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1184608879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEMAYEHU BEKELE MD

Provider Business Mailing Address
First Line	:	3435 W VANBURON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624
Country	:	US
Telephone Number	:	773-265-3435
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 W VANBURON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624
Country	:	US
Telephone Number	:	773-265-3435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/08/2007

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