Provider Demographics
NPI:1306826474
Name:CABRERA, JULIO (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:CABRERA
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 1:4041 BORDEAUX DR DEPT OF
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2139
Mailing Address - Country:US
Mailing Address - Phone:630-697-0080
Mailing Address - Fax:
Practice Address - Street 1:1775 DEMPSTER ST DEPT OF
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1143
Practice Address - Country:US
Practice Address - Phone:847-723-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36105764207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK05715OtherMEDICARE
IL36105764Medicaid
ILK05714Medicare ID - Type Unspecified
ILK05715OtherMEDICARE