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NPI Code Detail

MEDICARE: ANDREA TEKIE M.D.

MEDICARE: ANDREA TEKIE M.D.
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
1208000000XPediatrics Physician036.167598IL
2208000000XPediatrics Physician01071329AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2191360001OTHERINMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326372046
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA TEKIE M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number : 847-390-4757
Provider Business Practice Location Address
First Line : 9730 S WESTERN AVE STE 500
Second Line :
City : EVERGREEN PARK
State : IL
Zip : 60805-2780
Country : US
Telephone Number : 708-425-7337
Fax Number : 708-636-3485
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2009
Last Update Date : 04/05/2024

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Directions to “ ANDREA TEKIE M.D.” Practice Location

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