Individual provider Active NPI

Mary Jane Cabreros

  • Physical Therapist
  • Niles, IL
National Provider Identifier
1962891242
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014732 Issued in IL
Practice address
6930 W Touhy Ave
Niles, IL 60714-4522
Phone
(847) 647-0003
NPI assigned
Jan 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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 070014732 IL Primary

Addresses

Primary practice location

6930 W Touhy Ave
Niles, IL 60714-4522

Mailing address

7026 N Crawford Ave
Lincolnwood, IL 60712-2302

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
070014732ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1962891242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 N CRAWFORD AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 W TOUHY AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144522",
            "telephone_number": "847-647-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABREROS",
        "first_name": "MARY JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.