NPIMap

Individual provider Active NPI

Julio Cabrera, MD

  • Anatomic Pathology Physician
  • Park Ridge, IL
National Provider Identifier
1306826474
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
36105764 Issued in IL
Practice address
1775 Dempster St Dept of
Park Ridge, IL 60068-1143
Phone
(847) 723-7548
NPI assigned
Jan 17, 2006
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 36105764 IL Primary

Addresses

Primary practice location

1775 Dempster St Dept of
Park Ridge, IL 60068-1143

Mailing address

4041 Bordeaux Dr Dept of
Northbrook, IL 60062-2139
Phone (630) 697-0080

Other identifiers 2

IdentifierTypeStateIssuer
K05715OtherILMEDICARE
36105764MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ Direct
Direct Messaging Address jcabrera237600@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040603000533 IL Practitioner - Pathology 2668454646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Diagnostic Pathology, S.C.Group PAC ID 7911924428, 44 clinicians

Practice addresses (Care Compare)

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-2210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36105764ILMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Diagnostic Pathology SC CurrentSince Jan 1, 2017 Accepting new patients
Loyola University Physician Foundation Past Accepting new patients
Long Island Pathology Inc Past Accepting new patients

Locations

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1306826474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 BORDEAUX DR DEPT OF",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622139",
            "telephone_number": "630-697-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST DEPT OF",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "JULIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "IL",
            "license": "36105764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K05715",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36105764",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcabrera237600@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.