Individual provider Active NPI

Fikir Kibret, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1396572418
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.086119 Issued in IL
Practice address
1950 W Polk St
Chicago, IL 60612-3723
Phone
(312) 864-7311
NPI assigned
Sep 14, 2024
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 61594641 WA
Internal Medicine Physician 207R00000X 125.086119 IL Primary

Addresses

Primary practice location

1950 W Polk St
Chicago, IL 60612-3723

Mailing address

7001 Sand Point Way NE Unit C107
Seattle, WA 98115-6308
Phone (206) 698-2415

Other practice location 1

3725 Providence Point Dr SE
Issaquah, WA 98029-7219
Phone (425) 391-2800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250904002928 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4688107345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61594641WAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1726272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1396572418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 SAND POINT WAY NE UNIT C107",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156308",
            "telephone_number": "206-698-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-7311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3725 Providence Point Dr SE",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980297219",
            "country_code": "US",
            "telephone_number": "425-391-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIBRET",
        "first_name": "FIKIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-14",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "61594641",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.086119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.