Bertha Cabrera MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

036065550 Issued in IL

Legal business name

BERTHA CABRERA MD

Practice address

601 W Central Rd
Mt Prospect, IL 60056-2379

Phone

(815) 463-8994

Fax

(815) 463-8946

NPI assigned

Apr 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bertha Cabrera, M.D.

Title

President

Phone

(816) 463-8994

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1841465390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W CENTRAL RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562379",
            "telephone_number": "815-463-8994",
            "fax_number": "815-463-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W CENTRAL RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562379",
            "telephone_number": "815-463-8994",
            "fax_number": "815-463-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTHA CABRERA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "CABRERA",
        "authorized_official_first_name": "BERTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-463-8994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036065550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "036065550",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065550",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.