Provider Demographics
NPI:1093184582
Name:CABATU, JUAN LAWRENCE (MSN/MBA, NP-C)
Entity type:Individual
Prefix:MR
First Name:JUAN LAWRENCE
Middle Name:
Last Name:CABATU
Suffix:
Gender:M
Credentials:MSN/MBA, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 W ADAMS ST
Mailing Address - Street 2:UNIT 346
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2998
Mailing Address - Country:US
Mailing Address - Phone:224-430-8194
Mailing Address - Fax:
Practice Address - Street 1:1 WESTBROOK CORPORATE CTR
Practice Address - Street 2:SUITE 300
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5701
Practice Address - Country:US
Practice Address - Phone:877-906-9699
Practice Address - Fax:800-499-9260
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily