Individual provider Active NPI

Beamlak Dejene Adamu

  • Internal Medicine Physician
  • Berwyn, IL
National Provider Identifier
1710875588
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.085316 Issued in IL
Practice address
3231 Euclid Ave
Berwyn, IL 60402-3471
Phone
(464) 245-8557
NPI assigned
Jun 27, 2025
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.085316 IL Primary

Addresses

Primary practice location

3231 Euclid Ave
Berwyn, IL 60402-3471

Mailing address

3415 Oak Park Ave
Berwyn, IL 60402-3623
Phone (464) 245-8557

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
I20250722001394 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2163938648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1710875588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023623",
            "telephone_number": "464-245-8557"
        },
        {
            "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": "464-245-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMU",
        "first_name": "BEAMLAK",
        "middle_name": "DEJENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.085316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.