Provider Demographics
NPI:1558309922
Name:CABIN, RALPH V (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:V
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 1528
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-6008
Mailing Address - Country:US
Mailing Address - Phone:847-236-0512
Mailing Address - Fax:847-236-0528
Practice Address - Street 1:5600 W ADDISON ST
Practice Address - Street 2:SUITE 400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4401
Practice Address - Country:US
Practice Address - Phone:847-236-0512
Practice Address - Fax:847-236-0528
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL360444682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036044468Medicaid
ILL96193Medicare ID - Type UnspecifiedMEDICARE
IL036044468Medicaid