Provider Demographics
NPI:1851340855
Name:CABRERA, ERNEST C (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:C
Last Name:CABRERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ERNEST
Other - Middle Name:C
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:120 W 22ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1563
Mailing Address - Country:US
Mailing Address - Phone:630-573-5000
Mailing Address - Fax:312-633-5863
Practice Address - Street 1:2222 W DIVISION ST STE 260
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2990
Practice Address - Country:US
Practice Address - Phone:872-208-7619
Practice Address - Fax:773-483-2200
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099643207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036099643Medicaid