MEDICARE: DR. JOHN CABANA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	36076575	IL
2	208000000X	Pediatrics Physician	036-106796	IL

General Provider Information

NPI Number	:	1942225966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CABANA M.D.

Provider Business Mailing Address
First Line	:	6840 S. MAIN STREET
Second Line	:	SUITE 201
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516-3493
Country	:	US
Telephone Number	:	630-852-4551
Fax Number	:	630-852-0131

Provider Business Practice Location Address
First Line	:	6840 S. MAIN STREET
Second Line	:	SUITE 201
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516-3493
Country	:	US
Telephone Number	:	630-852-4551
Fax Number	:	630-852-0131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	11/17/2009

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Directions to “ DR. JOHN CABANA M.D.” Practice Location

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