Individual provider Active NPI

Jeffrey A. Cabotaje, M.D.

  • Pediatrics Physician
  • Oak Park, IL
National Provider Identifier
1417063041
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-105051 Issued in IL
Practice address
6853 North Ave
Oak Park, IL 60302-1023
Phone
(708) 383-3010
Fax
(708) 383-6475
NPI assigned
Aug 23, 2006
Last updated
Apr 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-105051 IL Primary

Addresses

Primary practice location

6853 North Ave
Oak Park, IL 60302-1023

Mailing address

6853 North Ave
Oak Park, IL 60302-1023
Phone (708) 383-3010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 22, 2016 through Apr 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-105051ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics Unlimited PLLC Current Accepting new patients
Rosa Hae S. Choi M.D., S.C. Past Accepting new patients

Locations

6853 North Ave
Oak Park, IL 60302
Phone (708) 383-3010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1417063041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6853 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021023",
            "telephone_number": "708-383-3010",
            "fax_number": "708-393-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6853 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021023",
            "telephone_number": "708-383-3010",
            "fax_number": "708-383-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABOTAJE",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-105051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.