Individual provider Active NPI

Michael Cabahug, PA-C

  • Physician Assistant
  • Libertyville, IL
National Provider Identifier
1023718129
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009922 Issued in IL
Practice address
890 Garfield Ave Ste 103
Libertyville, IL 60048-3100
Phone
(847) 279-0061
Fax
(847) 279-0069
NPI assigned
Mar 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.009922 IL Primary

Addresses

Primary practice location

890 Garfield Ave Ste 103
Libertyville, IL 60048-3100

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

507 North 17th Street
Milwaukee, WI 53233
Phone (414) 288-5688

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mcabahug358329@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240701003536 IL Practitioner - Physician Assistant 8325582398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

890 Garfield Ave
Libertyville, IL 60048-3100

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jun 1, 2024 Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Jun 1, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

Interoperability endpoints

  • Direct secure messaging: mcabahug358329@direct.myadvocateaurora.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1023718129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 GARFIELD AVE STE 103",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483100",
            "telephone_number": "847-279-0061",
            "fax_number": "847-279-0069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 North 17th Street",
            "address_purpose": "LOCATION",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53233",
            "country_code": "US",
            "telephone_number": "414-288-5688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABAHUG",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "890 Garfield Ave Ste 103",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcabahug358329@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "890 Garfield Ave Ste 103",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.