Healthcare Provider Details

I. General information

NPI: 1417295833
Provider Name (Legal Business Name): KIMBERLY N G CABRERA APN-CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST FEINBERG 5-704
CHICAGO IL
60611-2908
US

IV. Provider business mailing address

155 N HARBOR DR APT 1614
CHICAGO IL
60601-5001
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-2000
  • Fax:
Mailing address:
  • Phone: 773-988-4535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209010125
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041365165
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: