Active NPI
Abeselom Geletu, MD
- Hematology & Oncology Physician
- Chicago, IL
National Provider Identifier
1033798905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 036.170653
- Practice address
- 1725 W Harrison St Ste 821B
Chicago, IL 60612-3841 - Phone
- (312) 563-0621
- NPI assigned
- Apr 6, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 036.170653 | IL | Primary |
Addresses
Primary practice location
1725 W Harrison St Ste 821B
Chicago, IL 60612-3841
Mailing address
1725 W Harrison St Ste 821B
Chicago, IL 60612-3841
Phone (312) 563-0621
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210830002021 | MI | Order and Referring Only - Internal Medicine | 3375948359 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.170653 | IL | MD | Hematology & Oncology Physician |
Interoperability endpoints
- ageletu596035@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1033798905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST STE 821B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-563-0621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST STE 821B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-563-0621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELETU",
"first_name": "ABESELOM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-06",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "IL",
"license": "036.170653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.