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General NPI Number Information
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NPI Number | 1205019270
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Entity Type | Organization
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Legal Business Name | ERNESTO CABRERA MD
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1431 N WESTERN AVE SUITE 202
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City | CHICAGO
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State | IL
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Zip | 60622
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Country | US
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Telephone | 773-489-6605
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Fax | 312-633-5863
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Provider Business Mailing Address
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Address Line | 1431 N WESTERN AVE SUITE 202
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City | CHICAGO
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State | IL
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Zip | 60622
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Country | US
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Telephone | 773-489-6605
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Fax | 312-633-5863
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Authorized Official
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Title or Position | MEDICAL ASSISTANT
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Name | MRS. MARISSA SAYSON FERNANDEZ
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Credential | MEDICAL ASSISTANT
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Telephone | 773-489-6605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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