Provider Demographics
NPI:1235142241
Name:CABRERA, BERTHA L (MD)
Entity Type:Individual
Prefix:DR
First Name:BERTHA
Middle Name:L
Last Name:CABRERA
Suffix:
Gender:F
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 5064
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5064
Mailing Address - Country:US
Mailing Address - Phone:773-235-0474
Mailing Address - Fax:847-394-2185
Practice Address - Street 1:601 W CENTRAL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-2379
Practice Address - Country:US
Practice Address - Phone:773-235-0474
Practice Address - Fax:847-394-2185
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics