Individual provider Active NPI

Russel Raymund Yap Cabrera, PHYSICAL THERAPIST

  • Physical Therapist
  • Skokie, IL
National Provider Identifier
1487228789
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070023408 Issued in IL
Practice address
4632 Church St Ste 101
Skokie, IL 60076-1545
Phone
(847) 768-1050
Fax
(847) 768-1064
NPI assigned
May 20, 2021
Last updated
May 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070023408 IL Primary

Addresses

Primary practice location

4632 Church St Ste 101
Skokie, IL 60076-1545

Mailing address

6400 N Cicero Ave Apt 417
Lincolnwood, IL 60712-3448
Phone (312) 813-1816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070023408ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Admire Home Health Care Agency, Inc. CurrentSince Oct 16, 2022 Accepting new patients

Locations

4632 Church St
Ste 101
Skokie, IL 60076
Phone (847) 768-1050

Organizations & group practices 1

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1487228789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 N CICERO AVE APT 417",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123448",
            "telephone_number": "312-813-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 CHURCH ST STE 101",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761545",
            "telephone_number": "847-768-1050",
            "fax_number": "847-768-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "RUSSEL RAYMUND",
        "middle_name": "YAP",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.