Kidanu Birhanu MD SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036072060 Issued in IL

Legal business name

KIDANU BIRHANU MD SC

Practice address

5660 W 95TH St
Suite 3
Oak Lawn, IL 60453-2380

Phone

(708) 229-1395

Fax

(708) 857-4420

NPI assigned

Apr 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kidanu Birhanu, M.D

Title

Physician

Phone

(708) 229-1395

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19806/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1154548121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5660 W 95TH ST",
            "address_2": "SUITE 3",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532380",
            "telephone_number": "708-229-1395",
            "fax_number": "708-857-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5660 W 95TH ST",
            "address_2": "SUITE 3",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532380",
            "telephone_number": "708-229-1395",
            "fax_number": "708-857-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDANU BIRHANU MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "BIRHANU",
        "authorized_official_first_name": "KIDANU",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-229-1395",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036072060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01633358",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110248456",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salaam Khater
• Ahmad Khattab, MD
• Nacer Khenouche, CPO
• Zahra Khudeira, PHARMD
• Sameen Khurshid
• Kidney Care Center South LLC
• Anna L Kiernicki Sklar, MD
• Nicoletta A Kijak
• Brian Kilbane
• Eilis Sioban Kilbride, MD

• Internal Medicine Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.