Provider Demographics
NPI:1821130915
Name:CABRERA, SCOTT ARNOLD (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ARNOLD
Last Name:CABRERA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 HIGGINS RD.
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-384-8730
Mailing Address - Fax:847-384-8732
Practice Address - Street 1:712 HIGGINS RD.
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5716
Practice Address - Country:US
Practice Address - Phone:847-384-8730
Practice Address - Fax:847-384-8732
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203362Medicare ID - Type Unspecified