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Organization

BERTHA CABRERA MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BERTHA CABRERA M.D. (PRESIDENT)
(816) 463-8994
Entity
Organization

Contact information

Practice address
601 W CENTRAL RD, MT PROSPECT, IL 60056-2379
(815) 463-8994
(815) 463-8946
Mailing address
601 W CENTRAL RD, MT PROSPECT, IL 60056-2379
(815) 463-8994
(815) 463-8946

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
036065550
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036065550
BLUE CROSS BLUE SHIELD
IL
05
036065550
IL
Enumeration date
04/25/2008
Last updated
04/25/2008
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