KIDANU BIRHANU MD SC NPI 1619288339

NPI Information

  • NPI: 1619288339
  • Provider Name: KIDANU BIRHANU MD SC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 24 JOLIET ST
    SUITE 302
    DYER, IN
    ZIP 46311
  • Phone: (219) 852-2518

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NPI Details

KIDANU BIRHANU MD SC is a clinic center in Dyer, IN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). KIDANU BIRHANU MD SC NPI is 1619288339. The provider is registered as an organization entity type.

The provider's business location address is:

24 JOLIET ST
SUITE 302
DYER, IN
ZIP 46311-705
Phone: (219) 852-2518
Fax: (219) 864-2156

The provider's authorized official is Kidanu Birhanu .
The authorized official title is Owner and has the following contact phone number (708) 334-2352.

The enumeration date for this NPI number is 6/28/2010 and was last updated on 6/28/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center01066132AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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