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1457001562
ADDIS MEKONNEN
ROCKFORD, IL
NPI
1457001562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-03-24
Last Update Date
2022-03-24
Business Address
ADDIS MEKONNEN
2400 N ROCKTON AVE
ROCKFORD, IL 61103-3655
Phone number: 815-971-6364
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Mailing Address
ADDIS MEKONNEN
1111 S LAFLIN ST APT 714
CHICAGO, IL 60607-4654
Phone number: 312-723-2582
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