Amanuel Paulos Genebo

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

125085940 Issued in IL

Practice address

3231 Euclid Ave
Berwyn, IL 60402-3471

Phone

(708) 783-3401

NPI assigned

Jun 28, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Loyola Medical Group LLC

  • General Practice Physician
  • Berwyn, IL
  • NPI 1376041954
  NPD (past)

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

{
    "created_epoch": "1751068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1366331118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE STE 203",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604026700",
            "telephone_number": "708-783-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-783-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENEBO",
        "first_name": "AMANUEL",
        "middle_name": "PAULOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-28",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125085940",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "12.085940",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pietro Gaspari, MD
• Andrew Gattuso, D.D.S.
• Sanam Sandeep Gavankar
• Patricia Maureen Gavin, M.D.
• Tsegaye Wesenseged Gebreamlak
• Danielle Gengo, R.D.
• Nick Albert Geroulis, DDS
• Michael Gershberg, M.D.
• Gi and Liver Specialists, LTD
• Leslie Michele Giambalvo, RD

• Student in an Organized Health Care Education/Training Program in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.