Provider Demographics
NPI:1639240435
Name:CABANIT, SALVADOR A (MD)
Entity Type:Individual
Prefix:
First Name:SALVADOR
Middle Name:A
Last Name:CABANIT
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 1:2000 SPRING RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1804
Mailing Address - Country:US
Mailing Address - Phone:630-472-8800
Mailing Address - Fax:
Practice Address - Street 1:1060 S ELMHURST RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-4240
Practice Address - Country:US
Practice Address - Phone:630-690-9326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085771207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F65002Medicare UPIN