Provider Demographics
NPI:1073547659
Name:CABIN, MARK (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:CABIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 957243
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-7243
Mailing Address - Country:US
Mailing Address - Phone:847-843-3242
Mailing Address - Fax:846-843-0870
Practice Address - Street 1:1555 BARRINGTON RD.
Practice Address - Street 2:SUITE 120
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-843-3242
Practice Address - Fax:847-843-0870
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1625846OtherBS
G53693Medicare UPIN
575550Medicare PIN